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Computed tomography or ultrasonically guided pigtail catheter drainage in multiloculated pleural empyema: A recommended procedure?
Author(s) -
Maier Alfred,
Domej Wolfgang,
Anegg Udo,
Woltsche Michael,
Fell Birgit,
Pinter Hans,
SmolleJÜttner Freyja M.
Publication year - 2000
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1046/j.1440-1843.2000.00237.x
Subject(s) - medicine , decortication , thoracentesis , empyema , radiology , pigtail , surgery , pleural empyema , thoracotomy , catheter , pleural effusion , physics , optical fiber , optics
Objectives : The role of image‐guided pigtail catheter drainage in the treatment of pleural empyema is associated with different outcomes, dependent on the stage of the disease. No agreement concerning its use exists. Methodology : Fourteen patients at a fibropurulent stage of pleural empyema initially treated with computed tomography (CT) or ultrasonically guided pigtail catheter drainage were reviewed. All patients were admitted with clinical symptoms of sepsis. Chest X‐ray, CT scan and/or ultrasonography and thoracentesis with biochemical examination revealed multiloculated pleural empyema. Despite the diagnosis of multiloculated empyema, CT or ultrasonically guided pigtail catheter drainage was performed. However, septic symptoms deteriorated and all cases proceeded to thoracotomy with decortication. Results : Image‐guided drainage failed in all patients. Septic symptoms disappeared within 24– 48 h after decortication. The patients recovered without sequela, were discharged 6–15 days (mean: 9.2 days) postoperatively and were able to return to normal physical activity. Conclusions : Computed tomography or ultrasonically guided pigtail catheter drainage can not be recommended in the case of a fibropurulent stage of empyema thoracis.