Reappraisal of empyema thoracis. Surgical intervention when the duration of illness is unknown.
نویسندگان
چکیده
The timing of surgical treatment of empyema remains controversial. Traditionally, thoracotomy is performed either within three weeks of diagnosis or delayed until presumed pleurodesis occurs. Often, these patients are moribund and the duration of illness impossible to determine. We report our surgical results in seven patients with a deteriorating clinical course and multiple loculations which persisted after tube thoracostomy and would not have responded to multiple thoracostomies. Five patients required decortication. One required lobectomy for an abscess which developed on the contralateral side six weeks after discharge. There were no deaths or recurrences of empyema. Average times from surgery to tube removal and to discharge were six to 12 days, respectively. We conclude that one can safely and cost-effectively treat these patients surgically even when the duration of illness and presence of pleurodesis are unknown, and that the postoperative course will be uncomplicated.
منابع مشابه
Neonatal Empyema Thoracis: a case report
A term newborn was admitted to the neonatal intensive care unit immediately after the birth, with respiratory distress due to congenital pneumonia. With progression of respiratory symptoms, empyema thoracis was diagnosed due to the right massive purulent pleural effusion in chest X ray. Treatment was fulfilled by ventilator support and pus drainage by means of two chest tubes and appropriate an...
متن کاملEmpyema thoracis in children: clinical presentation, management and complications.
OBJECTIVE To determine the etiology, clinical manifestation, management (medical and surgical) and complications of children with empyema thoracis in a tertiary care hospital from Karachi, Pakistan. STUDY DESIGN Descriptive, analytical study. PLACE AND DURATION OF STUDY Department of Surgery, The Aga Khan University Hospital, Karachi, from January 1996 to December 2010. METHODOLOGY Medica...
متن کاملEmpyema thoracis in children: a short term outcome study.
This study prospectively evaluates clinical course of pyogenic empyema thoracis in 25 children (2 mo to 12 y) treated with injectable antibiotics and chest tube drainage, and followed for 6 weeks. The median (range) age at presentation was 3 y (4 mo to 11 y). The pleural fluid culture was positive in 24% of patients. Staphylococcus aureus was the most commonly isolated organism. The median (ran...
متن کاملICD Versus VATS as Primary Treatment in Fibrinopurulent Stage of Empyema Thoracis.
BACKGROUND AND OBJECTIVES Empyema thoracis is a condition in which pus collects in the pleural cavity. The optimal treatment of Empyema thoracis especially in the fibrinopurulent phase (Stage II) remains controversial. While the Inter Costal Drainage (ICD) is less invasive and cheap, it is not clearly proved that it is better than the Video Assisted Thoracoscopic Surgery (VATS) in terms of conv...
متن کاملEmpyema thoracis: Surgical management in children
Empyema thoracis can produce significant morbidity in children if inadequately treated. Correct evaluation of the stage of the disease, the clinical condition of the child and proper assessment of the response to conservative treatment is crucial in deciding the mode of further surgical intervention. This ranges from intercostal chest tube drainage and video-assisted thoracoscopic surgery to op...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Chest
دوره 90 4 شماره
صفحات -
تاریخ انتشار 1986