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Updated: Jul 27, 2025

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Two case reports of two interventional radiology techniques for the treatment of stage II empyema: Hydrodissection
Satoshi Yoshikawa1, Masahisa Nakamura2, Takeshi Ueda1
1Department of Emergency and General Internal Medicine, Rakuwakai Marutamachi Hospital, 9-7 Jurakumawari-Matsushita-cho, Nakagyo-ku, Kyoto 604-8401, Japan.
Abstract:
Empyema is an infection of the pleural space that is classified into 3 stages. Video-assisted thoracoscopic surgery is recommended as the first-line approach for stage II acute empyema. The purpose of video-assisted thoracoscopic surgery is also achieved with hydrodissection and guidewire-dissection by breaking the septa mechanically in the pleural cavity. Hydrodissection and guidewire-dissection are techniques in which a contrast medium is administered at high pressure and a guidewire is inserted into the pleural cavity to break the septa, respectively. Hydrodissection and guidewire-dissection might be minimally invasive alternatives for the treatment of septated empyema.
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