Objective: The aim of this study was to present computed tomography (CT) findings associated with the rupture of a pulmonary hydatid cyst (HC) and to assess related factors. HC rupture is a serious and potentially life-threatening complication of hydatid disease, also known as echinococcosis.
Materials and Methods: The case records of 125 patients with a confirmed pulmonary HC and who underwent CT evaluation were included and studied retrospectively. The CT images were analyzed for radiologic findings and signs of rupture, and the cysts were classified based on a manifestation of rupture and size (giant cyst).
Results: In the group, 52% of the patients were female. It was determined that 60.8% (n=76) of the cysts were solitary, and most were located in the right lung (n=71, 54.4%), lower lobes (n=83, 66.4%), or periphery (n=92, 73.6%). There were 64 (51.2%) ruptured cysts. The most common finding in cases of contained rupture cases was the air bubble sign (n=16, 12.8%), and the water lily sign (n=13, 10.4%) was most frequent in complete rupture cases. The rates of airway compression, consolidation, pleural effusion, cysto-bronchial fistula, and lung resection were significantly higher in cases of ruptured cysts, in addition to the length of hospitalization (p<0.05). The prevalence of giant cysts was 12.8% (n=6), and these cases demonstrated a significantly higher incidence of a central location, airway compression, consolidation, rupture, and elevated C-reactive protein level (p<0.05).
Conclusion: The majority of the pulmonary HCs reviewed were solitary and located in the lower lobes and periphery. The results revealed that the morbidity and lung resection rates, as well as length of hospitalization, were higher in cases of ruptured cysts as a result of airway compression, consolidation, and bronchial fistulas. Pulmonary HC should be evaluated with CT early and treated surgically to avoid further complications.