WHEN CHEST TRAUMA REVEALS A PULMONARY HYDATID CYST: ABOUT TWO CASES

Pulmonary hydatid disease remains endemic in Morocco. Although often asymptomatic, cyst rupture may cause severe thoracic complications, and blunt chest trauma is an uncommon trigger of rupture that can lead to acute respiratory manifestations. We report two cases of pulmonary hydatid cysts revealed by blunt chest trauma and complicated by pleural or bronchial rupture. A 34-year-old man involved in a road traffic accident developed cough and mild hemoptysis. Chest imaging showed a large right hydropneumothorax with complete lung collapse and a right lower-lobe cavity containing floating membranes. After emergency drainage, right lower lobectomy was performed because the cyst occupied the entire lobe. A 17-year-old adolescent presented after blunt anterior chest trauma with acute chest pain and dyspnea. Imaging revealed a right pneumothorax with an air-fluid level and an upper-lobe cavitary lesion. Chest drainage yielded serohematic fluid containing hydatid membranes. Pericystectomy with closure of bronchial fistulas and cavity padding was subsequently performed. Both patients had an uneventful postoperative course and received albendazole therapy. Blunt chest trauma can reveal pulmonary hydatid disease through cyst rupture. In endemic areas, hydatid cyst rupture should be considered when traumatic pneumothorax or hydropneumothorax is associated with characteristic cavitary lesions. Early diagnosis and appropriate surgical management are essential.