Transthoracic ultrasonography in diagnosis and treatment of acute pleural empyema

The aim of this study was to estimate validity of transthoracic ultrasonography in diagnosis and evaluation of the results of initial surgical therapy of acute pleural empyema. The study included 49 patients with II stage acute pleural empyema. Initial surgical tretament was indicated according to CT and transthoracic ultrasonography findings. Evaluation of initial therapy results has been made by transthoracic ultrasonography (TUS). Clinical significance of standard x-ray, CT and TUS in different stages of diagnostic and therapeutic procedure has been analyzed. Chest drainage was initial treatment in 10 (20.4%) patients, thoracentesis in 39 (79.6%). Complete cure with this two methods was achieved in 22 (44.9%) patients. In 27 (55.1%) patients initial treatment failed. TUS was sufficient for adequate estimate of initial treatment results in 41 (83.6%). Additional CT was indicated in 8 (16.3%) patients. Transthoracic ultrasonography has impotrant role in choice of initial surgical therapy of acute pleural empyema. If initial estimate of therapy results is made by TUS, CT is rarely necessary.