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Surgical Treatment of a Tuberculous Abscess of the Chest Wall

  • Keum, Dong-Yoon (Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Kim, Jae-Bum (Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Park, Chang-Kwon (Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine)
  • Received : 2012.01.26
  • Accepted : 2012.02.28
  • Published : 2012.06.05

Abstract

Background: Tuberculous abscess of the chest wall is a very rare disease. Few articles have reported on it and those that have enrolled few patients. To determine the characteristics of this disease and to suggest an optimal treatment strategy, we reviewed patients treated by surgical management. Materials and Methods: Between October 1981 and December 2009, 68 patients treated by surgical management for a tuberculous abscess of the chest wall were reviewed retrospectively. Results: Of 33 men and 35 women, 31 patients had a current or previous history of tuberculosis. The main complaints were chest pain, a palpable mass, pus discharge, and coughing. A preoperative bacteriologic diagnosis was performed in 12 patients. Abscess excision was performed in 54 cases, abscess cavity excision and partial rib resection in 13, and abscess excision and partial sternum and clavicle excision in 1 case. Postoperative wound infection was noted in 16 patients and a secondary operation was performed in 1 patient. Recurrence occurred in 5 patients (7.35%). Reoperation with abscess excision and partial rib resection was performed in all of the 5 cases. Conclusion: Complete excision of the abscess and primary closure of the wound with obliteration of space would decrease postoperative complications. Anti-tuberculosis medication may reduce the chance of recurrence.

Keywords

References

  1. Enarson DA, Ashley MJ, Grzybowski S, Ostapkowicz E, Dorken E. Non-respiratory tuberculosis in Canada. Epidemiologic and bacteriologic features. Am J Epidemiol 1980; 112:341-51. https://doi.org/10.1093/oxfordjournals.aje.a113000
  2. Hsu HS, Wang LS, Wu YC, Fahn HJ, Huang MH. Management of primary chest wall tuberculosis. Scand J Thorac Cardiovasc Surg 1995;29:119-23. https://doi.org/10.3109/14017439509107217
  3. Chen CH, Shih JF, Wang LS, Perng RP. Tuberculous subcutaneous abscess: an analysis of seven cases. Tuber Lung Dis 1996;77:184-7. https://doi.org/10.1016/S0962-8479(96)90036-2
  4. Kuzucu A, Soysal O, Gunen H. The role of surgery in chest wall tuberculosis. Interact Cardiovasc Thorac Surg 2004;3: 99-103. https://doi.org/10.1016/S1569-9293(03)00192-0
  5. Sakuraba M, Sagara Y, Komatsu H. Surgical treatment of tuberculous abscess in the chest wall. Ann Thorac Surg 2005;79:964-7. https://doi.org/10.1016/j.athoracsur.2004.09.004
  6. Faure E, Souilamas R, Riquet M, et al. Cold abscess of the chest wall: a surgical entity? Ann Thorac Surg 1998;66: 1174-8. https://doi.org/10.1016/S0003-4975(98)00770-X
  7. Kim YT, Han KN, Kang CH, Sung SW, Kim JH. Complete resection is mandatory for tubercular cold abscess of the chest wall. Ann Thorac Surg 2008;85:273-7. https://doi.org/10.1016/j.athoracsur.2007.08.046
  8. Cho KD, Cho DG, Jo MS, Ahn MI, Park CB. Current surgical therapy for patients with tuberculous abscess of the chest wall. Ann Thorac Surg 2006;81:1220-6. https://doi.org/10.1016/j.athoracsur.2005.10.044
  9. Lee G, Im JG, Kim JS, Kang HS, Han MC. Tuberculosis of the ribs: CT appearance. J Comput Assist Tomogr 1993;17: 363-6. https://doi.org/10.1097/00004728-199305000-00004
  10. Brown TS. Tuberculosis of the ribs. Clin Radiol 1980;31: 681-4. https://doi.org/10.1016/S0009-9260(80)80022-5
  11. Blunt SB, Harries MG. Discrete pleural masses without effusion in a young man: an unusual presentation of tuberculosis. Thorax 1989;44:436-7. https://doi.org/10.1136/thx.44.5.436
  12. Weissberg D. Invited commentary: Cold abscess of the chest wall: a surgical entity? Ann Thorac Surg 1998;66:1178. https://doi.org/10.1016/S0003-4975(98)00771-1
  13. Paik HC, Chung KY, Kang JH, Maeng DH. Surgical treatment of tuberculous cold abscess of the chest wall. Yonsei Med J 2002;43:309-14. https://doi.org/10.3349/ymj.2002.43.3.309
  14. Cho S, Lee EB. Surgical resection of chest wall tuberculosis. Thorac Cardiovasc Surg 2009;57:480-3. https://doi.org/10.1055/s-0029-1186066
  15. Tanaka S, Aoki M, Nakanishi T, et al. Retrospective case series analysing the clinical data and treatment options of patients with a tubercular abscess of the chest wall. Interact Cardiovasc Thorac Surg 2012;14:249-52. https://doi.org/10.1093/icvts/ivr113

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