Clinical Presentation, Localization and Morphology of Hepato-Pulmonary Hydatid Cysts in Patients Operated in Tehran

Cystic echinococcosis (CE), also known as hydatid disease, is an important zoonotic infection and public health problem in many areas of the world including Iran. A ten-year (1999–2009) retrospective study was carried out to investigate the medical files of the patients who operated on for hepatic and pulmonary cystic echinococcosis in Shohada-Tajrish and Imam Hossein hospitals, Tehran (capital of Iran). 177 patients (162 cases with hepatic hydatid cyst and 15 cases with pulmonary hydatid cyst), with a mean age of 40 years (range 6–82), were operated on for hydatid disease at two government university hospitals in Tehran. Most of our patients with hepatic hydatid cyst were pain on the right upper quadrant (32.10%), abdominal pain (26.54%) and nausea and vomiting (23.46%), whereas the commonest manifestations in those with pulmonary CE were cough (40%), dyspnea (33.33%), sputum production (33.33%), diminished breath sound (33.33%), chest pain (26.67%), haemoptysis (26.67%) and fever (26.67%). 27.16% of hepatic CE and 26.67% of pulmonary CE were asymptomatic. The present study indicated that the right lobe liver is affected in approximately threequarters of hepatic hydatid disease. Although pulmonary cysts may establish in every lobe of the lungs, but they are more frequent in the right hemithorax. The size of the hydatid cysts ranged from 1.5 to 23 cm in their greater diameter and the largest cyst was approximately 23 ×18 cm. Among 132 intact and uncomplicated cystic echinococcosis lesions 31(23.5%) were smaller than 6 cm, 63 (47.7%) were between 6–10 cm, 25 (18.9%) were between 11–15 cm and 13 (9.9%) larger than 15 cm.