title: Treatment of spontaneous rupture of lung hydatid cysts into a bronchus in children.
abstract: OBJECTIVE
  While several publications have reported the treatment of ruptured lung hydatid cysts (HC) in adults, there is limited information on the treatment of children. This study summarizes the treatment approach and outcomes of 11 children with spontaneous rupture of lung HCs into a bronchus.
  
  
  METHODS
  The complete medical records of 11 patients with spontaneous lung HC bronchus rupture between March 1993 and April 2012 were examined retrospectively. Gender, age at the time of diagnosis, patient symptoms, lung localization, dimensions of the cyst, medical treatment duration, and associated morbidities were evaluated. Routine chest x-rays, ultrasonography, computed tomography and serological tests were used.
  
  
  RESULTS
  The study included 11 patients [4 males, 7 females; average age 7.45 (range 5-11) years] presenting to the Emergency Department. The symptoms at the time of presentation were coughing in 81.8% (n=9), hemoptysis in 54.5% (n=6), and chest pain in 54.5% (n=6). The average cyst diameter was 8.71(35-15) cm. The rupture involved the left lung in 7 (63.6%) patients and the right in 4 (36.4%). Serological tests were positive in seven patients and all patients had eosinophilia. The treatment of one patient was discontinued, while all of the other patients were treated medically. Pneumonia developed in four patients and lung abscesses in two. Both patients who developed lung abscesses had cysts with diameters greater than 10 cm. The average follow-up period was 48.4 (range 15-85) months; no mortality occurred.
  
  
  CONCLUSIONS
  In our experience, medical treatment is adequate for patients with lung HCs progressing to spontaneous bronchus rupture. There was a high rate of abscess development within the thoracic cavity in patients with cysts over 10 cm in diameter; these patients can be treated effectively with a medical approach.
authors.affiliation: Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280 Diyarbakir, Turkey. Electronic address: bahattinaydogdu@hotmail.com.
authors.forename: Bahattin
authors.initials: B
authors.lastname: Aydogdu
authors.affiliation: Department of Pediatric Surgery, İstanbul Kanuni Sultan Suleyman Education And Research Hospital, 34303, İstanbul, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Sander
authors.affiliation: Department of Pediatric Surgery, İstanbul Kanuni Sultan Suleyman Education And Research Hospital, 34303, İstanbul, Turkey.
authors.forename: Oyhan
authors.initials: O
authors.lastname: Demirali
authors.affiliation: Department of Pediatric Surgery, İstanbul Kanuni Sultan Suleyman Education And Research Hospital, 34303, İstanbul, Turkey.
authors.forename: Unal
authors.initials: U
authors.lastname: Guvenc
authors.affiliation: Department of Pediatric Surgery, İstanbul Kanuni Sultan Suleyman Education And Research Hospital, 34303, İstanbul, Turkey.
authors.forename: Cemile
authors.initials: C
authors.lastname: Besik
authors.affiliation: Department of Pediatric Infectious Diseases, İstanbul Kanuni Sultan Suleyman Education and Research Hospital, 34303 İstanbul, Turkey.
authors.forename: Canan
authors.initials: C
authors.lastname: Kuzdan
authors.affiliation: Department of radiology, Medical Faculty of Dicle University, 21280 Diyarbakir, Turkey.
authors.forename: Cemil
authors.initials: C
authors.lastname: Goya
authors.affiliation: Department of Pediatric Surgery, İstanbul Kanuni Sultan Suleyman Education And Research Hospital, 34303, İstanbul, Turkey.
authors.forename: Gulay
authors.initials: G
authors.lastname: Tireli
mesh_terms: D000328:Adult; D001980:Bronchi; D001982:Bronchial Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D004445:Echinococcosis, Pulmonary / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D019616:Thoracic Surgical Procedures / Q000379:methods*; D014057:Tomography, X-Ray Computed
keywords: Hydatid cyst; Management; Rupture; Spontaneous