• Journal of Chest Surgery
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• v.13 no.1
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• pp.26-33
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• 1980

The incidence of the empyema thoracis has been drastically reduced with the advent of antimicrobial drugs. Empyema thoracis is however still dealt with one of major problems in thoracic surgery because of difficulties in the management of associated bronchopleural fistula. During the period of January 1975 to June 1979, 145 patients of empyema thoracis were treated in the Department of Thoracic Surgery, Busan National University Hospital. This reports dealed especially with the incidence, etiology and management of chronic empyema thoracis with B.P.F. and estimated the results of intercostal myoplasty. The results: 1 ] Among 145 empyema thoracis patients, 33 patients [22.7%] had bronchopleural fistula. 2] Male predominated in general with the ratio of 4:1 and in empyema thoracis with B.P.F. male predominance was further more prominent with the ratio of 10:1. Peak incidence of chronic empyema thoracis lay on 3rd and 4th decade. 3] The most common causation of empyema thoracis was pneumonia [77.3%] in children and tuberculosis [48.8%] in adult. 4] The most common causative organism of empyema thoracis was staphylococcus aureus [52.5%]. 5] Among 40 cases of resection for pulmonary tuberculosis, 4 cases developed empyema thoracis with B.P.F. [10%], and resection for another underlying pathology was 2.1%. 6] In contrast to good prognosis of acute empyema thoracis, chronic empyema thoracis with B.P.F. was improved only 66.6% of cases. 81.5% of chronic empyema without B.P.F. were cured completely. 7] Intercostal myoplasty were performed in 21 cases of empyema thoracis with B.P.F. and of which 15 cases showed that fistula were closed. 8] The over all mortality rate in empyema thoracis was 8.7%. The mortality rate of chronic empyema thoracis with and without B.P.F. was 15.2% and 5.3% respectively.

• Journal of Korean Neurosurgical Society
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• v.49 no.3
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• pp.175-177
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• 2011

Subdural empyema is a rare form of intracranial sepsis associated with high morbidity and mortality. The most frequent cause is extension of paranasal sinusitis through emissary veins or of mastoiditis through the mucosa, bone, and dura mater. Development of subdural empyema after pyogenic meningitis is known to be very unusual in adults. We report a rare case of fatal subdural empyema, an unusual complication of pyogenic meningitis. Our bitter experience suggests that subdural empyema should be borne in mind in patient with pyogenic meningitis who exhibit neurological deterioration.

• Journal of Chest Surgery
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• v.25 no.6
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• pp.593-597
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• 1992

The bronchopleural fistula[BPF] due to bronchial stump disruption after pneumonec-tomy has remained one of the most dreadful complications to now. The management of the BPF with empyema thoracis are still therapeutic dilemma even though a various surgical methods for the control of BPF with or without empyema thoracis. We have experienced the successful treatment of BPF & empyema thoracis with transsternal transpericardial approach. The patient was a 54 years old male who was taken left pneumonectomy at W. Medical Center at sept, 19th. 1991. He was suffered from the BPF R empyema thoracis and so was transferred to our hospital at Nov. 19th. 1991. We treated the patient with transsternal transpericardial bronchial closure for BPF, and put clagett procedure for empyema thoracis in 2 weeks. We think this kind of surgical techniques is one of the relatively simple and effective method for the control of BPF and empyema thoracis.

• Journal of Chest Surgery
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• v.37 no.2
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• pp.188-192
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• 2004

Treatment of huge chronic tuberculous empyema with cardiopulmonary dysfunction. Drainage of empyemal space by closed thoracostomy in chronic tuberculous empyema is generally contraindicated because of the possibility of empyema necessitatis and ascending infection. But in case that serious cardiopulmonary dysfunction is present, drainage of empyema and decompression is necessary. We experienced a case in which chronic tuberculous empyema was big enough to cause mediastinal shifting and cardiopulmonary failure. Immediate drainage of pleural cavity with tube thoracostomy was performed. Afterward, pleuropneumonectomy was done following cyclic irrigation for one month. The patient had successful postoperative course without any evidence of complication or relapse of infection.

• Journal of Chest Surgery
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• v.9 no.2
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• pp.125-132
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• 1976

The author made clinical study of 100 cases of empyema in infancy and childhood that were treated at the Department of Chest Surgery, Busan University Hospital and Busan Children's Charity Hospital, from Jan 1962 to Nov. 1975. 1. In infancy and childhood, 62 cases out of my 100 cases of empyema were caused by .staphylococci and most of recent reports showed a gradual increase in number of staphylococcal empyema. 2. Most frequent lesion predisposing to empyema in infancy and childhood was pneumonia (72%), being remarkable in staphylococcal empyema (85.5%) to that of others. 3. Antibiotics sensitivity test for staphylococci revealed that the erythromycin was most susceptible (85. 5%). 4. The mortality rate was 6% in over all and the author believes that from the point of view of surgical treatment, failure of early continuous drainage on account of multiple thoracentesis for the early stage of empyema, and also early open thoracotomy procedure such as decortication were all the contributing factors to higher mortality in the empyema of infancy and childhood. 5. It may be concluded that the treatment of choice for empyema in infancy and childhood were early and prolonged continuous drainage of pus by closed thoracotomy with caution and administration of more susceptible antibiotics with nutritional support.

• Journal of Chest Surgery
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• v.19 no.3
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• pp.385-390
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• 1986

Empyema is a severe infection encountered in the pediatrics. With advance of the antibiotics and chemotherapeutics, there was a marked decrease in number of empyema. Empyema complicated by staphylococcal pneumonia in infant and children has been distressing problem, and the management of this complication has been discussed repeatedly in the past. In Korea, tuberculous empyema is also troublesome. If empyema is localized within thick capsule, tube thoracostomy and closed drainage alone is unacceptable, and early open thoracotomy to eliminate the empyema has proved good result. A clinical analysis of 39 patients with thoracic empyema was done. They were managed surgical intervention at Dept. of Thoracic & Cardiovascular Surgery at Kyung-Hee University Hospital from Jan. 1974 to December, 1984. 1. Age and sex distribution, infancy 9, early childhood 11. late childhood 9, puberty 10. The male to female ratio was 21:18. 2. The highest seasonal incidence was winter [21 cases]. 3. Cardinal symptoms were cough [76%], fever and chill [66%], and dyspnea [40%]. 4. The location of the empyema was right in 27 cases [69%] and 12 cases in left side. 5. The most frequent lesion to predisposing factor was pneumonia [67%]. 6. The commonest organism was Staphylococcus aureus in 15 [38%] cases, and Mycobacterium tuberculosis in 10 cases [26%]. 7. The surgical treatment was performed in all patients. The surgical procedure was closed tube thoracostomy in 25 cases [64%], decortication in 7 cases [18%], pulmonary resection in 4 cases [10%], and decortication with curettage in 2 cases. 8. One patient died from sepsis complicated by lymphoma and in one patient bronchopleural fistula was developed postoperatively.

• Journal of Chest Surgery
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• v.15 no.3
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• pp.274-277
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• 1982

A Clinical analysis of 59 patients of thoracic empyema was done who were received surgical intervention at dept. of thoracic surgery of the C.A.F.G.H. in the period of 2.5 years from January 1979 to June 1982. Occurrence ratio of Left and Right side pleural cavity of empyema was 1: 1.4. The predisposing factors of empyema were pulmonary Tbc. [49%], Chest pain [25%], Cough [8%], in order. B.P.F. was associated with empyema in 5 cases. The pleural cavity empyema was treated with several surgical procedures and conservative measures. Among of the 59 cases, the 30 cases [50%] were treated with decortication, 12 cases [20%] with closed thoractomy drainage, 9 cases with frequent thoracenteses, 5 cases with partial decortication and thoracoplasty and 3 cases with open thoracostomy tube drainage. Among of the 59 cases thoracic empyema, the full recovery were in 32 cases [54%], partial recovery in 20 cases [34%], not improved in 3 cases [5%] and 3 cases were died. The mortality rate was 5% and the recovery rate was 89%.

• Journal of Chest Surgery
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• v.22 no.5
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• pp.851-856
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• 1989

Initial successful treatment of postpneumonectomy empyema depends to a large extent on adequate dependent drainage of the empyema sac and the use of antibiotics. But definite control of the infected space remains a disturbing and controversial area in the field of thoracic surgery. A 55-year-old man had a right pneumonectomy for tuberculosis with the development of postoperative thoracic empyema and in October 1973. Postoperatively, an empyema developed and the condition was managed with closed drainage and an open window thoracostomy. He was transferred to our institution in October 1988, and underwent thoracoplasty for the obliteration of the empyema space, resulting in a remaining space. The remaining space after thoracoplasty was obliterated by myoplasty using a rotation flap of splitted pectoralis major muscle three months later. He was discharged with uneventful course 12 days after operation, and continues to do well 3 months following operation. Our experience shows that thoracoplasty and myoplasty offer an effective alternative method of management of post-pneumonectomy empyema.

• Journal of Chest Surgery
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• v.28 no.5
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• pp.504-506
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• 1995

Postpneumonectomy empyema is an infrequent but dreaded complication. The seriousness of this complication is impossible to eliminate the space containing the infection, and consequently, it is difficult to sterilize the space. The time from pneumonectomy to the development of an empyema ranges from several days to several years, with most evident with 4 weeks. We experienced a case of postpneumonectomy empyema that occurred 27 1/2 years after initial pneumonectomy. She was treated with intrapleural antiseptic irrigation and open-tube drainage following partial decortication. The patient had an uneventful recovery and was discharged from hospital with improved condition.

• Journal of Chest Surgery
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• v.26 no.7
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• pp.571-574
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• 1993

We present a rare case of malignant lymphoma developing from the wall of chronic empyema thoracis. A 54-year old man with a 35 year history of tuberculosis empyema was admitted due to right chest pain and general weakness for 2 months. Under the impression of chronic empyema thoracis with destroyed right lung and tumor on posterior costophrenic sulcus, pleuropneumonectomy including tumor was performed as a single procedure through a right thoracotomy. The tumor arose from the thickened pleura, and it was histologically and immunologically diffuse large cell[non-cleaved] B-cell non-Hodgkin`s lymphoma [NHL]