A 12-year-old boy was brought to the emergency department with chest pain, difficulty in breathing, rapid heart rate, cyanosis, and fainting. Chest radiography revealed a tension pneumothorax (Figure 1). Subsequently, a chest drain was inserted to relieve this into the left lung, followed by an emergency surgery. The surgeons performed left thoracotomy, cystotomy, and capitonnage of a large ruptured hydatid cyst in the upper lobe of the left lung. The patient was discharged without complications on the post-operative tenth day.

FIGURE 1:
Chest radiograph showing a tension pneumothorax on the left, mediastinal shift to the right (arrows), and a ruptured hydatid cyst (asterisk).

Hydatid cyst disease is a benign clinical condition that is easy to diagnose and treat in endemic areas¹1. Aydin Y, Ulas AB, Ince I, Korkut E, Ogul H, Eren S, et al. Large Case Series Analysis of Cystic Echinococcosis. Indian J Surg. 2021;83(Suppl 4):S897-S906. Available from: https://doi.org/10.1007/s12262-021-03061-0.
https://doi.org/10.1007/s12262-021-03061... . However, pulmonary hydatid cyst rupture can lead to life-threatening complications²2. Aydin Y, Ulas AB, Ahmed AG, Eroglu A. Pulmonary Hydatid Cyst in Children and Adults: Diagnosis and Management. Eurasian J Med. 2022;54(Suppl1):133-40.. Unlike other causes, tension pneumothorax due to a pulmonary hydatid cyst requires surgical and antiparasitic treatment to prevent recurrence, unlike other causes³3. Rezaei R, Sadidi H, Taqanaki PB. Tension pneumothorax caused by the ruptured hydatid cyst of the lung. Clin Case Rep. 2023;11(7):e07542.. In such cases, tension pneumothorax should be controlled, and hydatid cysts should be treated surgically as soon as possible. Pulmonary hydatid cysts should be considered as a rare cause of tension pneumothorax.

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