Empyema surgery: Difference between revisions
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==Surgery== | ==Surgery== | ||
Treatment of empyema focuses on the following:<ref name="pmid27815709">{{cite journal| author=Reichert M, Hecker M, Witte B, Bodner J, Padberg W, Weigand MA et al.| title=Stage-directed therapy of pleural empyema. | journal=Langenbecks Arch Surg | year= 2016 | volume= | issue= | pages= | pmid=27815709 | doi=10.1007/s00423-016-1498-9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27815709 }} </ref> | |||
*Controlling the infectious focus | |||
*Drainage of fluid and pus | |||
*Re-expansion of the lung | |||
===Surgery and Device Based Therapy=== | ===Surgery and Device Based Therapy=== | ||
Definitive treatment for empyema entails drainage of the infected pleural fluid. A [[chest tube]] may be inserted, often using ultrasound guidance. [[Intravenous]] [[antibiotic]]s are given. If this is insufficient, surgical [[debridement]] of the pleural space may be required.<ref name="pmid27815709">{{cite journal| author=Reichert M, Hecker M, Witte B, Bodner J, Padberg W, Weigand MA et al.| title=Stage-directed therapy of pleural empyema. | journal=Langenbecks Arch Surg | year= 2016 | volume= | issue= | pages= | pmid=27815709 | doi=10.1007/s00423-016-1498-9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27815709 }} </ref><ref name="pmid11035692">{{cite journal| author=Colice GL, Curtis A, Deslauriers J, Heffner J, Light R, Littenberg B et al.| title=Medical and surgical treatment of parapneumonic effusions : an evidence-based guideline. | journal=Chest | year= 2000 | volume= 118 | issue= 4 | pages= 1158-71 | pmid=11035692 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11035692 }} </ref><ref name="pmid2019172">{{cite journal| author=Ashbaugh DG| title=Empyema thoracis. Factors influencing morbidity and mortality. | journal=Chest | year= 1991 | volume= 99 | issue= 5 | pages= 1162-5 | pmid=2019172 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2019172 }} </ref> | Definitive surgical treatment for empyema entails drainage of the infected pleural fluid. A [[chest tube]] may be inserted, often using ultrasound guidance. [[Intravenous]] [[antibiotic]]s are given. If this is insufficient, surgical [[debridement]] of the pleural space may be required.<ref name="pmid27815709">{{cite journal| author=Reichert M, Hecker M, Witte B, Bodner J, Padberg W, Weigand MA et al.| title=Stage-directed therapy of pleural empyema. | journal=Langenbecks Arch Surg | year= 2016 | volume= | issue= | pages= | pmid=27815709 | doi=10.1007/s00423-016-1498-9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27815709 }} </ref><ref name="pmid11035692">{{cite journal| author=Colice GL, Curtis A, Deslauriers J, Heffner J, Light R, Littenberg B et al.| title=Medical and surgical treatment of parapneumonic effusions : an evidence-based guideline. | journal=Chest | year= 2000 | volume= 118 | issue= 4 | pages= 1158-71 | pmid=11035692 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11035692 }} </ref><ref name="pmid2019172">{{cite journal| author=Ashbaugh DG| title=Empyema thoracis. Factors influencing morbidity and mortality. | journal=Chest | year= 1991 | volume= 99 | issue= 5 | pages= 1162-5 | pmid=2019172 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2019172 }} </ref> | ||
===Empyema necessitans=== | ===Empyema necessitans=== | ||
Revision as of 17:46, 4 January 2017
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Empyema Microchapters |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Prince Tano Djan, BSc, MBChB [2]
Overview
Surgery
Treatment of empyema focuses on the following:[1]
- Controlling the infectious focus
- Drainage of fluid and pus
- Re-expansion of the lung
Surgery and Device Based Therapy
Definitive surgical treatment for empyema entails drainage of the infected pleural fluid. A chest tube may be inserted, often using ultrasound guidance. Intravenous antibiotics are given. If this is insufficient, surgical debridement of the pleural space may be required.[1][2][3]
Empyema necessitans
Management strategies of Empyema necessitans with pulmonary involvement and lung abscess may involve thoracotomy with pulmonary resection in addition to extended duration antimicrobial therapy.[4][5]
References
- ↑ 1.0 1.1 Reichert M, Hecker M, Witte B, Bodner J, Padberg W, Weigand MA; et al. (2016). "Stage-directed therapy of pleural empyema". Langenbecks Arch Surg. doi:10.1007/s00423-016-1498-9. PMID 27815709.
- ↑ Colice GL, Curtis A, Deslauriers J, Heffner J, Light R, Littenberg B; et al. (2000). "Medical and surgical treatment of parapneumonic effusions : an evidence-based guideline". Chest. 118 (4): 1158–71. PMID 11035692.
- ↑ Ashbaugh DG (1991). "Empyema thoracis. Factors influencing morbidity and mortality". Chest. 99 (5): 1162–5. PMID 2019172.
- ↑ Atay S, Banki F, Floyd C (2016). "Empyema necessitans caused by actinomycosis: A case report". Int J Surg Case Rep. 23: 182–5. doi:10.1016/j.ijscr.2016.04.005. PMC 5022073. PMID 27180228.
- ↑ Gomes MM, Alves M, Correia JB, Santos L (2013). "Empyema necessitans: very late complication of pulmonary tuberculosis". BMJ Case Rep. 2013. doi:10.1136/bcr-2013-202072. PMC 3863066. PMID 24326441.