Hydatid hepatothoracic fistulas. A report of 30 cases.

A retrospective study was carried out on 30 patients with hepatothoracic transdiaphragmatic fistulas, classified as hepatopleural (5 cases), hepatopulmonary (11 cases), biliopleural (1 case) and biliobronchial (13 cases). Investigations included chest X-rays, bronchography, plain abdominal films, cholecystocholangiography, liver scanning, ultrasonography and CT scanning. Twenty-nine patients were submitted to 32 operations: two were performed in 1 case and three in another. Thoracotomy was performed in 20 cases, laparotomy in 7 and thoracophrenolaparotomy in 5. Surgical procedures for the treatment of endothoracic lesions included pleurectomy, middle lobectomy, lower lobectomy and wedge resections. Liver cysts were treated by cystectomy and pericystectomy. The postoperative course was uneventful in 21 patients. Complications developed in 3 patients. Operative mortality was 10.3%.