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[Pleural empyema]

L Sunder-Plassmann1

  • 1Abteilung für Thorax- und Gefässchirurgie, Universität Ulm.

Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|October 23, 1998
PubMed
Summary
This summary is machine-generated.

Thoracic empyema, an infection in the chest, has four causes and three stages. Treatment depends on the stage, ranging from chest tube drainage to surgery for advanced disease.

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Area of Science:

  • Pulmonology
  • Thoracic Surgery
  • Infectious Diseases

Context:

  • Thoracic empyema presents with diverse etiologies including parapneumonic, post-traumatic, post-specific, and post-surgical infections.
  • The disease progresses through three distinct morphologic stages: exudative, fibrino-purulent, and organization with pleural peel formation.

Purpose:

  • This review outlines the etiologic mechanisms, staging, diagnostic modalities, and therapeutic strategies for thoracic empyema.
  • To provide a comprehensive overview of thoracic empyema management based on disease stage and morphology.

Summary:

  • Diagnosis relies on thoracic CT and ultrasonography, guiding pleural puncture.
  • Early-stage empyema (Stage I and early Stage II) may be treated with chest tube drainage and irrigation.

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  • Advanced or organized empyema necessitates surgical intervention, including video-assisted debridement or open thoracotomy with decortication or empyemectomy.

    • Impact:

    • Optimal treatment requires addressing the infection source and ensuring complete lung reexpansion.
    • Effective management aims to prevent restrictive peels and air leaks for improved patient outcomes.
    • Understanding the stages and etiologies is crucial for selecting appropriate interventions and improving thoracic empyema treatment efficacy.