A pulmonary hernia against pressure regime: a residual cavity related complication following liver hydatic cyst surgery: Case Report

Résumé

Echinococcosis raises a public health issue in many countries, although it is, in principle, preventable, treatable and eradicable. Surgery is the keystone of its treatment. Conservative procedures offer fewer per-operative complications but predisposes to post-operative complications. Herein we report an unprecedented complication of the residual cavity: an intra-abdominal transdiaphragmatic pulmonary hernia occurring 3 years after the index surgery. A 64-year-old woman with no relevant medical history, consulted for dull hepatalgia with no respiratory complains. Radio-imaging concluded to a pulmonary hernia into the residual cavity. Taking into consideration the well tolerated abdominal discomfort and the potentially risky surgery, she was scheduled for a close follow-up. To our best knowledge, this is the first publication of intra-abdominal pulmonary hernia. Normally, herniation follows the pressure gradient present between thoracic and abdominal cavities. The consequences can be dreadful because of the threat to the pulmonary parenchyma, from the reduction of its functional capacity to its necrosis. Operation will be restricted to cases of functional respiratory repercussions or important pulmonary contusion