Respir Case Rep. 2014; 3(3): 169-172 | DOI: 10.5505/respircase.2014.46320

Alýþýlmadýk Bir Ýntratorasik Ekstrapulmoner Hidatik Kist Olgusu

Halil Tözüm¹, Haydar Yalman², Canan Eren³, Salih Bölük², Tahir Þevval Eren^1
1Ýstanbul Medeniyet Üniversitesi Göztepe Eðitim Araþtýrma Hastanesi Göðüs Cerrahi Ad
²Ýstanbul Medeniyet Üniversitesi Göztepe Eðitim Araþtýrma Hastanesi Genel Cerrahi Ad
³Ýstanbul Marmara Üniversitesi Pendik Eðitim Araþtýrma Hastanesi Klinik Mikrobiyoloji Ad

On iki yýl önce kist hidatik tanýsý ile sol alt lobektomi ve splenektomi yapýlmýþ olan yirmi dört yaþýndaki erkek hasta, sol yan aðrýsý þikayeti ile baþvurdu. Yapýlan radyolojik incelemelerde, üzüm salkýmý görüntüsü olarak tariflenebilecek görüntüler elde edildi. Hastaya bu halde nüks kist hidatik ön tanýsý ile sol eksploratrif torakotomi yapýldý. Üst lob altýnda, diafragma ile çok sýký yapýþýklýklar geliþtirmiþ ve içi yüzlerce kýz vezikülle dolu büyük bir poþ bulundu. Poþ temizlendiðinde diafragmanýn orta kýsmýnýn da erimiþ olduðu ve buradan batýna açýlan bir aðýzla benzer bir kist poþunun da retroperitoneal bölgede yerleþmiþ olduðu tespit edildi. Diafragma açýlarak retroperitoneal poþ da uygun þekilde boþaltýlýp, temizlendi. Hasta postoperatif 16. ayda sorunsuz olarak takip edilmektedir.

Anahtar Kelimeler: Hidatik kist, intratorasik ekstrapulmoner, kistektomi, albendazol

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An Extraordinary Case Of Intrathoracic Extrapulmonary Hydatid Cyst

Halil Tözüm¹, Haydar Yalman², Canan Eren³, Salih Bölük², Tahir Þevval Eren^1
1Istanbul Medeniyet University Goztepe Training And Research Hospital, Department Of Thoracic Surgery
²Istanbul Medeniyet University Goztepe Training And Research Hospital, Department Of General Surgery
³Istanbul Marmara University Pendik Training And Research Hospital, Department Of Clinical Microbiology

A 24-year-old male, who had a history of left lower lobectomy and splenectomy due to hydatid cyst 12 years ago, applied to our clinic with a severe pain localized in the left hemithorax that had continued for approximately six months. Radiological studies displayed interesting images resembling “a bunch of grapes”. An exploratory thoracotomy was performed with an initial diagnosis of recurrent hydatid cyst. Beneath the left upper lobe, a giant pleural pouch with tight adhesions extending to the diaphragm was present. Inside the pouch, hundreds of daughter cysts were observed. In the middle of the diaphragm there was a dissolved area and with an opening from this point, a similar pouch located at the retroperitoneal space was found. With a transdiaphragmatic approach, both pouches were drained and cleaned appropriately. At the 16th month of postoperative follow-up, patient had no complaints.

Keywords: Hydatid cyst, intrathoracic extrapulmonary, cystectomy, albendazole

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ATIF KOPYALA