HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hoover, E. L. Articles by Cunningham, J. N. Search for Related Content PubMed PubMed Citation Articles by Hoover, E. L. Articles by Cunningham, J. N.

The Annals of Thoracic Surgery, Vol 46, 563-566, Copyright © 1988 by The Society of Thoracic Surgeons

ARTICLES

The surgical management of empyema thoracis in substance abuse patients: a 5-year experience

EL Hoover, HK Hsu, H Webb, B Toporoff, E Minnard and JN Cunningham
Divisions of Thoracic Surgery, Meharry Medical College, Nashville, TN 37208.

Postpneumonic empyema (EMP) may develop in substance abuse patients, requiring prolonged hospitalization. An algorithm that provides quality care and a rational basis for timely surgical intervention would be advantageous. We report our five-year experience with EMP in substance abuse patients and present such a treatment plan. Sixty-one substance abuse patients were treated for EMP. Posteroanterior, lateral, and decubitus x-ray studies were obtained before treatment to assess fluid movement. Chest tubes were placed to drain frank pus and to obtain material for positive smears. X-ray studies and computed tomography were done 24 hours later to assess parenchymal pathology and to detect any multiple loculations. Thirty-three substance abuse patients recovered following initial tube thoracostomy and 7 after a second chest tube was introduced. Twenty-one had multiple loculations and underwent thoracotomy. Twenty of the 21 required extensive debridement or decortication, or both; 2 required lobectomy and 1 pneumonectomy. Chest tubes were removed on an average of 6 +/- 1.5 days. Average postoperative stay was 10.7 +/- 2 days. There were 2 early deaths and 1 late death and no recurrent EMP. Bacteriology findings were nonspecific and often polymicrobial. We conclude that early thoracotomy can be lifesaving in the presence of a benign clinical course.

This article has been cited by other articles:

				F. Farjah, R. G. Symons, B. Krishnadasan, D. E. Wood, and D. R. Flum Management of pleural space infections: A population-based analysis J. Thorac. Cardiovasc. Surg., February 1, 2007; 133(2): 346 - 351. [Abstract] [Full Text] [PDF]

				G. L. Colice, A. Curtis, J. Deslauriers, J. Heffner, R. Light, B. Littenberg, S. Sahn, R. A. Weinstein, and R. D. Yusen Medical and Surgical Treatment of Parapneumonic Effusions : An Evidence-Based Guideline Chest, October 1, 2000; 118(4): 1158 - 1171. [Abstract] [Full Text] [PDF]

				T. A. Angelillo Mackinlay, G. A. Lyons, D. J. Chimondeguy, M. A. Barboza Piedras, G. Angaramo, and J. Emery VATS Debridement Versus Thoracotomy in the Treatment of Loculated Postpneumonia Empyema Ann. Thorac. Surg., June 1, 1996; 61(6): 1626 - 1630. [Abstract] [Full Text]