Unforeseen pulmonary destruction following hepatic hydatid cyst fistulization: A case report of emergency pneumonectomy in a critically ill patient

Abstract

Direct fistulization of a hepatic hydatid cyst into the lung, causing rapid pulmonary destruction, is exceedingly rare. We report a 41-year-old male presenting with acute asphyxia due to a complicated hepatic hydatid cyst with a giant transdiaphragmatic fistula into the right lung, leading to complete lung destruction and massive tracheobronchial aspiration. Emergency right pneumonectomy was performed for irreversible lung damage. Intraoperative findings confirmed heavy adhesions, lung destruction, and an extensive scolex-laden fistula. The postoperative course was challenging, complicated by ARDS and Acinetobacter sepsis, requiring prolonged ICU care, though follow-up was ultimately successful. This case highlights the aggressive progression of this rare complication and the crucial importance of early diagnosis and comprehensive surgical intervention in endemic areas to prevent devastating outcomes.