EMPYEMA THORACIS: MANAGEMENT OUTCOME
AbstractBackground: Empyema thoracis results from postpneumonic effusion of bacterial origin or trauma. Ifuntreated it may convert to fibro-purulent or an organising stage. Methods: This study was conductedat cardiothoracic unit of Ayub Teaching Hospital Abbottabad from Jan 2008 to Aug 2009. Patients withdiagnosis of empyema thoracic were studied. Their clinical features and investigations were recordedon a proforma. Antibiotics alone, aspiration, chest intubation, rib resection or decortication wereperformed where required. Results: Out of 71 patients, males were 58 (81.69%) and females were 13(18.3%). Majority of the patients (24, 33.8%), were below 20 years of age. Most of the patients (59,83.09%), were from the poor socioeconomic class. Forty-one (57.76%) patients were smokers, 12(16.9%) were diabetic, and 39 (54.92%) were hypertensive. Cough was the most common complain(62, 87.32%). Forty (56.33%) had more than 50% involvement of hemi thorax. In 44 (61.97%) cases,cause was tuberculosis. Fifty-one (71.83%) patients were treated with tube thoracostomy and 13(18.3%) required decortication. Conclusion: Empyema thoracis commonly affects males. Apart fromclinical assessment, x-ray chest is an important and simple investigation to detect empyema thoracic.Mostly tube drainage cures the diseases but in case of failure other options are also available.Keywords: Empyema thoracic, Chest intubation, rib resection, decortication
Light RW. A new classification of parapneumonic effusions and
empyema. Chest 1995;108:299–301.
Rzyman W, Skokowski J, Romanowicz G, Lass P, Dziadziuszko
R. Decortications in chronic pleural empyema-effect on lung
function. Eur J Cardiothorac Surg 2002;21:502–7.
Huang HC, Chang HY, Chen CW, Lee CH, Hsiue TR.
Predicting factors for outcome of tube thoracostomy in
complicated parapneumonic effusion or empyema. Chest
Berger HA, Morganroth ML. Immediate drainage is not required
for all patients with complicated parapneumonic effusions. Chest
Thourani VH, Brady KM, Mansour KA, Mille JI, Lee RB.
Evaluation of treatment modalities for thoracic empyema: a costeffectiveness analysis. Ann Thorac Surg 1998;66:1121–7.
Ris HB, Pezzetta E, Krueger T, Lardinois D. Surgical treatment
of pleural infections: the surgeon's point of view. Eur Respir
Mon 2004; 29:181–8.
Waller DA, Rengarajan A. Thoracoscopic decortication: a role
for video-assisted surgery in chronic postpneumonic pleural
empyema. Ann Thorac Surg 2001; 71:1813–6.
Roberts J R. Minimally invasive surgery in the treatment of
empyema: intraoperative decision making. Ann Thorac Surg
Nadeem A, Bilal A, Shah S A. Presentation and management of
Empyema Thoracis at Lady Reading Hospital Peshawar. J Ayub
Med Coll Abbottabad 2004;16(1):14–7.
Misthos P, Sepsas E, Konstantinou M, Athanassiadi K, Skottis I,
Lioulias A. Early use of intrapleural fibrinolytics in the
management of postpneumonic empyema. A prospective study.
Eur J Cardiothorac Surg 2005;28:599–603.
Molnar T F. Current surgical treatment of thoracic empyema in
adults. Eur J Cardiothorac Surg 2007;32:422–30.
Bilal A, Nabi M S, Salim M, Zaman M, Muslim M. Collapse
therapy in 21st century an experience of 50 cases. Ann King
Edward Med Coll 2005;11(1):24–6.
Mandal AK, Thadepalli H, Mandal AK, Chetipally U. Outcome
of primary emypema thoracis: therapeutic and microbiologic
aspects. Ann Thorac Surg 1998;66:1782–6.
Angelillo-Mackinlay TA, Lyons GA, Chimondeguy DJ, Piedras
MA, Angaramo G, Emery J. VATS debridement versus
thoracotomy in the treatment of loculated postpneumonia
empyema. Ann Thorac Surg 1996;61:1626–30.
Lardinois D, Gock M, Pezzetta E, Buchli C, Rousson V, Furrer
M, Ris HB. Delayed referral and gram-negative organisms
increase the conversion thoracotomy rate in patients undergoing
videoassisted thoracoscopic surgery for empyema. Ann Thorac
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