Pulmonary cyst embolism: a rare complication of hydatidosis.

Hydatid disease is an endemic parasitosis that results from the ingestion of echinococcosis tapeworm eggs. This condition leads to the formation of cysts, mainly in the liver and lungs, and causes life-threatening complications. Cardiac involvement represents only 0.5-2% of the localizations. We report a rare case of a pulmonary cyst embolism that required emergency surgical intervention.

Liver hydatid cyst leading to bilateral pulmonary artery embolism and bilateral multiple pulmonar echinococcosis via inferior vena cava: report of a case.

Hydatid disease (HD) is a worldwide parasitic disease. Echinococcosis may involve many organs but affect most commonly liver and lungs. The location of echinococcal cysts inside pulmonary artery is extremely rare. Radiologic findings range from purely cystic lesions to a completely solid appearance. Hydatid cysts (HC) can be solitary or multiple and varies size. Pulmonary artery embolism of HC can be symptomatic or asymptomatic. When symptomatic, we see the chest pain, dyspnea, cough, hemoptysis and sometimes acute cor pulmonale or sudden death secondary to massive giant pulmonary artery embolism of HC.

[Hydatic pulmonary embolism: a rare complication of hepatic hydatid cyst]. / Embolie pulmonaire d'origine hydatique : une complication rare du kyste hydatique du foie.

Hepato-pulmonary hydatidosis is a parasitic disease common in Mediterranean countries. Hydatid pulmonary embolism is extremely rare and is due to rupture of a cardiac hydatid cyst or, more rarely, rupture of a hepatic hydatid cyst. We report three cases of hydatid pulmonary embolism secondary to rupture of a hydatid cyst into the inferior vena cava. Thoracic imaging, mainly CT angiography and MRI, was important for both the diagnosis and decisions on treatment. The prognosis of intra-arterial pulmonary hydatid cyst is poor because of the risk of acute fatal complications such as anaphylactic shock and vascular rupture and also of chronic progression to cor pulmonale and respiratory failure. The therapeutic management is difficult and often only partially effective hence the importance of focusing on preventative treatment.

Recurrent pulmonary embolism due to echinococcosis secondary to hepatic surgery for hydatid cysts.

We describe the case of a 53-year-old man with recurrent pulmonary embolism due to intra-arterial cysts from Echinococcus. Both the patient's medical history and the computed tomographic (CT) scan abnormalities led to the diagnosis. The CT scan, performed during hospitalization in our ward, showed cystic masses in the left main pulmonary artery and in the descending branch of the right pulmonary artery. Within cystic masses, thin septa were visible, giving a chambered appearance, which was suggestive of a group of daughter cysts. In the past, our patient underwent multiple operations for recurring echinococcal cysts of the liver. After the last intervention, 4 years earlier, his postoperative course was complicated by pulmonary embolism: a CT scan showed a filling defect in the descending branch of the right pulmonary artery, which was caused by the same cystic mass as 4 years later, although smaller. This mass, not properly treated, increased in diameter. Moreover, after 4 years, there has been a new episode of embolism, which involved the left main pulmonary artery. This is the first case in which there are repeated episodes of pulmonary embolism echinococcosis after hepatic surgery for removal of hydatid cysts.

CT demonstration of pulmonary embolism due to the rupture of a giant hepatic hydatid disease.

Hydatid disease can be seen anywhere in the body and presents with a variety of clinical symptoms and imaging features according to its location. In this article, computed tomography features of a giant hepatic hydatid cyst extending into the right atrium and causing pulmonary embolism are presented.

A cardiac hydatid cyst underlying pulmonary embolism: a case report.

Hydatid cysts located in the interatrial septum are especially rare but when they occur, they might cause intracavity rupture. We report on a patient with acute pulmonary embolism caused by an isolated, ruptured hydatid cyst on the right side of the interatrial septum. A 16-year-old-boy with an uneventful history was hospitalized for exercise-induced dyspnea and blood expectorations. Multiple and bilateral opacities were visualized on standard chest x-ray. Signs of right-sided hypertrophy were seen on ECG. Imaging findings led to the diagnosis of pulmonary embolism complicating cardiac hydatid cysts. An operation was performed through median sternotomy to remove the cardiac cyst. The pleural cavity was entered through the fifth intercostal space to withdraw lung hydatid cysts. Operative recovery was uneventful and the patient resumed his normal activities 19 months later. Prompt diagnosis and an appropriate surgical treatment prevented a potentially fatal outcome.

[Rare cause of pulmonary embolism in a child]. / Embolie pulmonaire hydatique chez un enfant.

Cardiac hydaticyst is a rare condition and accounts for only 0.5 to 2% of all visceral locations of hydatid disease. The objective of this study was to point out the main clinical, radiological, and disease-course characteristics of this rare and serious pathology. We report a 13-year-old patient with a hydatid pulmonary embolism caused by a hydatid cyst of the interauricular septum. The diagnosis was established by transthoracic echocardiography, thoracic CT scan, and hydatid serology. Surgery was performed without delay and the outcome was good after 15 months of follow-up. This case underlines the need for rapid diagnosis and surgery before complications of cardiac hydatid cyst.

Pulmonary artery embolism due to a ruptured hepatic hydatid cyst: clinical and radiologic imaging findings.

Hydatid pulmonary embolism is an uncommon condition resulting from the rupture of a hydatid heart cyst or the opening of a visceral hydatid cyst into the venous circulation. We report a rare case with multiple intra-arterial pulmonary hydatid cyst emboli originating from a hepatic hydatid cyst ruptured into the hepatic segment of the inferior vena cava. We present the ultrasonography findings of hepatic hydatid cyst and multidetector computed tomography pulmonary angiography images demonstrating both multiple hydatid cyst emboli and their hepatic origin.

[Hydatid disease diagnosed following a pulmonary embolism]. / Une hydatidose diagnostiquée à l'occasion d'une embolie pulmonaire.

Hydatidosis is a parasitic disease found worldwide, particularly in Mediterranean countries, caused by Echinococcus granulosis infection. Humans are an intermediate and accidental host in the cycle of this parasite. The hydatid pulmonary arterial embolism is extremely rare, usually arising in the heart or the liver. We report a case of hydatid pulmonary embolism explored with multidetector scanner and MRI, and confirmed at pathology of the operative specimen. To our knowledge, this is the first case of inaugural hydatid pulmonary arterial embolism found on CT scan establishing the diagnosis of the disease in a patient who had no other location of hydatid cyst.

Isolated pericardial and intracardiac hydatidosis: presentation as congestive cardiac failure and fatal pulmonary embolism.

Localization of hydatid cysts in the heart is a rare phenomenon, with an incidence of 0.5-2%. In almost half these cases, the heart is the sole organ to be involved. We report a case of massive pericardial hydatidosis in a female patient who presented with features of congestive cardiac failure. Cysts in the endocardium of right side of the heart resulted in fatal pulmonary embolism.

[Fatal hydatid pulmonary embolism. Report of two cases]. / Embolie pulmonaire hydatique fatale. A propos de deux observations.

Hydatid pulmonary embolism is rare but serious. The cause is usually the rupture of a cyst in the right cardiac chambers and less frequently the opening of an hepatic cyst into the venous circulation. We report two cases of hydatid pulmonary embolism following the rupture of a cyst in the right atrial cavity in one case and fistulisation of an hepatic cyst into the inferior vena cava in the second case. The course is dramatic in the two cases.

Capnografia volumétrica como auxílio diagnóstico não-invasivo no tromboembolismo pulmonar agudo / Volumetric capnography as a noninvasive diagnostic procedure in acute pulmonary thromboembolism

O tromboembolismo pulmonar é uma situação freqüente que pode ser diagnosticada pela cintilografia pulmonar, angiotomografia computadorizada, arteriografia pulmonar e, como método de exclusão, dosagem do dímero-D. Como estes exames nem sempre estão disponíveis, a validação de outros métodos diagnósticos é fundamental. Relata-se o caso de uma paciente com hipertensão pulmonar crônica, agudizada por tromboembolismo pulmonar. Confirmou-se o diagnóstico por cintilografia, angiotomografia computadorizada, arteriografia pulmonar; a dosagem do dímero-D resultou positiva. A capnografia volumétrica associada à gasometria arterial foi realizada na admissão e após o tratamento. As variáveis obtidas foram comparadas com os resultados dos exames de imagem.

Pulmonary thromboembolism is a common condition. Its diagnosis usually requires pulmonary scintigraphy, computed angiotomography, pulmonary arteriography and, in order to rule out other diagnoses, the measurement of D-dimer levels. Due to the fact that these diagnostic methods are not available in most Brazilian hospitals, the validation of other diagnostic techniques is of fundamental importance. We describe a case of a woman with chronic pulmonary hypertension who experienced a pulmonary thromboembolism event. Pulmonary scintigraphy, computed angiotomography and pulmonary arteriography were used in the diagnosis. The D-dimer test result was positive. Volumetric capnography was performed at admission and after treatment. The values obtained were compared with the imaging test results.

Ruptured hydatid cyst of the interventricular septum with acute embolic pulmonary artery complications.

Hydatid cysts located in the interventricular septum are especially rare but with the high risk for intracavitary rupture. We report a patient with acute pulmonary embolism caused by an isolated, ruptured hydatid cyst on the right side of the interventricular septum. Early diagnosis was made by echocardiography and positive serology. Pulmonary artery embolism was confirmed by angiography and the patient was operated on. Embolectomy was performed by removing multiple fragments of ruptured endocyst from the left pulmonary artery, followed by surgical closure of a cyst cavity. Prompt diagnosis and an appropriate surgical treatment prevented a potentially fatal outcome.