[Chronic hemorrhagic empyema developed in thirty three years after the right pneumonectomy--a case report]

A 55-year-old man was admitted because of exertional dyspnea. He had the right pneumonectomy thirty three years ago. Chest X-ray showed the mediastinal shift to the left. And chest CT scan showed right intrathoracic mass. The bloody pleural effusion was aspirated (Hb 9.4 g/dl) and its examination revealed Staphylococcus epidermidis. We resected the empyema cavity. During the operation, massive bleeding was experienced (total 23200 ml). Pathologically, micro blood vessels were marked in the organized hematomas and the pleura. Chronic hemorrhagic empyema is a specific type of chronic empyemas and it is dangerous to remove of the hematomas because of massive bleeding.