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    Extrapulmonary intrathoracic hydatid cysts
    (Cma-Canadian Medical Assoc, 2004) Ülkü, R; Eren, N; Çakir, Ö; Balci, A; Onat, S
    Introduction: Hydatid disease, a clinical entity endemic in many sheep- and cattle-raising areas, is still an important health problem in the world. Extrapulmonary location of cysts in the thorax is rare. We report our experience with intrathoracic but extrapulmonary hydatid cysts and discuss concepts of treatment. Method: In our Thoracic and Cardiovascular Surgery Department at the Dicle University School of Medicine, 133 patients with thoracic hydatid cysts were managed surgically between January 1990 and October 2002. In 14 (10.5%), the cysts were extrapulmonary but within the thorax, located in the pleural cavity, mediastinum, pericardium and diaphragm, or in pleural fissures. Cysts were intact in 12 patients and ruptured in 2. Radiographs of the chest were the main means of diagnosis; all patients with mediastinal and diaphragmatic cysts and some with pleural cysts were also scanned with computed tomography. All patients were managed surgically. Results: We operated on 3 mediastinal, 2 diapragmatic and 1 pericardial hydatid cyst, as well as 6 in pleural fissures and 2 in the pleural space. Lateral thoracotomy was chosen as the surgical incision in all patients except 1 (7% of the 14), who had median sternotomy lot a pericardial hydatid cyst. Empyema developed in 2 patients (morbidity, 14%). No patient died perioperatively. Conclusions: Hydatid cysts may be found in many different sites. Surgery to obtain a complete cure is the treatment of choice for most patients with intrathoracic but extrapulmonary cysts; excision must be done without delay to avoid or relieve compression of surrounding vital structures.
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    Giant intrathoracic extrapulmonary hydatid cyst manifested as unilateral pectus carinatum
    (Southern Medical Assn, 2002) Nazaroglu, H; Balci, A; Bükte, Y; Simsek, M
    Liver and lung are the most common sites of hydatid disease, but it can also be seen elsewhere in the body. Extrapulmonary intrathoracic location of the disease is rare. This case of giant intrathoracic extrapulmonary hydatid cyst manifested as unilateral pectus carinatum serves to illustrate that hydatid disease can produce various symptoms and that it may also exist in locations apart from lung and liver.
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    Phrenic nerve injury after blunt trauma
    (Int College Of Surgeons, 2005) Ülkü, R; Onat, S; Balci, A; Eren, N
    Phrenic nerve injury resulting from blunt trauma is unusual and may closely mimic diaphragmatic rupture. Diagnosis remains difficult and is often delayed. A prompt diagnosis requires a high index of suspicion. We describe one patient with phrenic nerve injury in whom the diagnosis was made late at the time of injury. Radiograph, ultrasonography, and computed tomography were helpful in the diagnosis. Video-assisted thoracic surgery was performed on our patient for diagnostic purposes. Left phrenic nerve injury and pericardial injury were found. Diaphragmatic plication was performed through a miniature left posterolateral thoracotomy. This case was presented to show the unusual nature of phrenic nerve injury.