Transbronchial Catheter Drainage via Fiberoptic Bronchoscope in Intractable Lung Abscess

The use of the fiberoptic bronchoscope as a drainage procedure for lung abscess has become more and more widespread. We have recently adopted the technique of inserting a simple polyethylene catheter through the flexible fiberoptic bronchoscope into the abscess cavity of 11 patients with lung abscess. All cases had not responded to aggressive postural drainage and adequate antibiotic therapy for at least a week. The results were as follows: 1) Among 11 patients, the therapeutic response was dramatic in 6 patients. 2) In the successful group, the abscess sizes were greater than 8cm in diameter and the airfluid levels were higher than two-thirds of the cavity. 3) Additional diagnoses, other than bacterial lung abscess, could be made in 2 cases when otherwise the diagnosis would have remained in doubt. The authors suggest that catheter drainage via fiberoptic bronchoscope is an effective treatment modality in the large lung abscess with a high air-fluid level which is intractable to other medical approaches, and it is also a safe procedure.