Adult ; Empyema, Pleural ; complications ; etiology ; Humans ; Male ; Neck Injuries ; complications ; Tracheoesophageal Fistula ; complications ; etiology

Actinomycosis ; complications ; Adult ; Empyema, Pleural ; etiology ; Female ; Humans ; Liver Diseases ; complications

Alkanes ; adverse effects ; Empyema ; chemically induced ; complications ; Humans ; Male ; Middle Aged ; Pneumonia ; chemically induced ; complications

PURPOSE: This study was to evaluate the safety and conversion rate of laparoscopic cholecystectomy (LC) after percutaneous transhepatic gallbladder drainage (PTGBD) in patients with a complicated acute cholecystitis (GB empyema, gangrenous cholecystitis and pericholecystic abscess) according to the timing of LC. METHODS: One hundred and four patients, who underwent a laparoscopic cholecystectomy after PTGBD between March 2004 and December 2006, were analyzed. Thirty-four patients underwent LC within 7 days after PTGBD (early group, n=34) and 38 patients underwent LC between 14 and 39 days after PTGBD (delayed group, n=38). Thirty-two patients were excluded because of gallbladder cancer (n=2), simple acute cholecystitis (n=12), a history of previous abdominal surgery (n=5), and LC between 8 and 13 days after PTGBD (n=13). RESULTS: There was no significant difference in age (early group, 58.4+/-11.2; delayed group, 61.0+/-12.1), diagnosis, duration of symptoms, WBC counts, interval of admission and PTGBD, improvement of symptoms after PTGBD, American Society of Anesthesiologists (ASA) score, prior medical history, post-PTGBD and postoperative complications, and operation time. The rate of conversion to an open laparotomy was 14.7% (5/34) in the early group and 2.6% (1/38) in the delayed group (statistically not significant). CONCLUSION: The timing of LC after PTGBD for a complicated acute cholecystitis does not influence the rate of conversion to an open laparotomy, surgery time and complication. However, a delayed LC after PTGBD tends to decrease the rate of conversion to an open laparotomy.
Cholecystectomy, Laparoscopic* ; Cholecystitis ; Cholecystitis, Acute* ; Diagnosis ; Drainage* ; Empyema ; Gallbladder Neoplasms ; Gallbladder* ; Humans ; Laparotomy ; Postoperative Complications

Diffuse malignant mesothelioma is a rare malignant tumor having poor prognosis. There is still no widely acceptable staging system of the disease and pathologic diagnosis is difficult. Although surgical treatment for diffuse malignant mesothelioma has been controversial, extrapleural peumonectomy in selected patients could prolong the survival when it was combined with adjuvant chemotherapy and radiation therapy. We experienced 4 cases of diffuse malignant mesothelioma for 7 years since 1992, they were treated with extrapleural pneumonectomy without early postoperative mortality. Three patients underwent adjuvant therapy after surgery; chemotherapy in two, and chemo-radiation therapy in one, but one patient could not receive adjuvant therapy because of postoperative complication of hypoxic brain damage due to cardiac torsion and empyema. In this article, we describe surgical experience of extrapleural pneumonectomy and discuss about the controversial points of the disease.
Chemotherapy, Adjuvant ; Diagnosis ; Drug Therapy ; Empyema ; Humans ; Hypoxia, Brain ; Mesothelioma* ; Mortality ; Pneumonectomy* ; Postoperative Complications ; Prognosis

BACKGROUND: this study was designed to estimate whether specific risk factors could increase the postoperative complication rate of pneumonectomy for chronic complicated inflammatory lung disease. MATERIAL AND METHOD: Eighty-five patients underwent pneumonectomy for chronic complicated inflammatory lung disease(tuberculosis, 67 ; bronchiecasis 11; aspergiolosis, 4; others, 3) between January 1991 and August 1998. We performed a univariated statistical analysis to identify preoperative and intraoperative risk factors associated with postoperative complications, RESULT: There was no operative mortality. There were a total of 18 postoperative complications(22.2%) Bronchopleural fistula(BPF) and empyema occurred in 5(5.9%) and 2(2.4%) respectively. General complication rate was significantly higher in patients with right-sided pneumonectomy(p=.029) extrapleural pneumonectomy(p=.009) and intraoperative pleural spillage due to cavity or lesion perforation (p=.004). The prevalence of BPF and empyema was higher in patients with right sided pneumonectomy(p=.007) extrapleural pneumonectomy(p=.015) and intraoperative pleural spillage due to cavity or lesion perforation(p=.003) which is as the same results as general complication rate. CONCLUSIONS: The postoperative complication rate of pneumonectomy for chronic complicated lung disease is accptably low. But it is increase in patients with right sided pneumonectomy extrapleural pneumonectomy and intraoperative pleural spillage due to cavity or lesion perforation. therefore more careful and meticulous intra-operatve management are needed in right sided extrapleural pneumonectomy without intra-pleural spillage.
Empyema ; Humans ; Lung Diseases* ; Lung* ; Mortality ; Pneumonectomy* ; Postoperative Complications* ; Prevalence ; Risk Factors

Gastropleural fistula is a very rare disorder, caused by various conditions, such as trauma and postoperative complication, subphrenic abscess, malignancy, hiatal hernia. The major causes of the gastropleural fistula have changed from trauma and subphrenic abscess to postoperative complication of malignant disorders. We report a case of empyema that developed respiratory failure caused by gastropleural fistula in a middle age woman with review of related articles.
Empyema ; Female ; Fistula* ; Hernia, Hiatal ; Humans ; Middle Aged ; Postoperative Complications ; Respiratory Insufficiency* ; Subphrenic Abscess

Adolescent ; Empyema, Subdural ; etiology ; Female ; Humans ; Sinusitis ; complications ; Tomography, X-Ray Computed

Objective: To examine the feasibility and technical considerations of thorough debridement using uniportal thoracoscopic surgery for tuberculous empyema complicated by chest wall tuberculosis. Methods: A retrospective analysis was conducted on 38 patients who underwent comprehensive uniportal thoracoscopy debridement for empyema complicated by chest wall tuberculosis in the Department of Thoracic Surgery, Shanghai Pulmonary Hospital, from March 2019 to August 2021. There were 23 males and 15 females, aged (M(IQR)) 30 (25) years (range: 18 to 78 years). The patients were cleared of chest wall tuberculosis under general anesthesia and underwent an incision through the intercostal sinus, followed by the whole fiberboard decortication method. Chest tube drainage was used for pleural cavity disease and negative pressure drainage for chest wall tuberculosis with SB tube, and without muscle flap filling and pressure bandaging. If there was no air leakage, the chest tube was removed first, followed by the removal of the SB tube after 2 to 7 days if there was no obvious residual cavity on the CT scan. The patients were followed up in outpatient clinics and by telephone until October 2022. Results: The operation time was 2.0 (1.5) h (range: 1 to 5 h), and blood loss during the operation was 100 (175) ml (range: 100 to 1 200 ml). The most common postoperative complication was prolonged air leak, with an incidence rate of 81.6% (31/38). The postoperative drainage time of the chest tube was 14 (12) days (range: 2 to 31 days) and the postoperative drainage time of the SB tube was 21 (14) days (range: 4 to 40 days). The follow-up time was 25 (11) months (range: 13 to 42 months). All patients had primary healing of their incisions and there was no tuberculosis recurrence during the follow-up period. Conclusion: Uniportal thoracoscopic thorough debridement combined with postoperative standardized antituberculosis treatment is safe and feasible for the treatment of tuberculous empyema with chest wall tuberculosis, which could achieve a good long-term recovery effect.
Male ; Female ; Humans ; Abscess/complications* ; Empyema, Pleural/etiology* ; Empyema, Tuberculous/complications* ; Retrospective Studies ; Thoracic Wall ; Debridement/adverse effects* ; China ; Chest Tubes/adverse effects* ; Tuberculosis/complications* ; Thoracic Surgery, Video-Assisted ; Drainage

Pleuropulmonary involvement of salmonella infection is very rare and only two cases of salmonella empyema have been reported in Korea. We report the case of a 70-year-old female diabetic patient who presented with right flank pain and right lower chest pain. The chest radiographs revealed fibrostreaky and hazy density at right lower lung field and blunting of right costophrenic angle. Thoracentesis revealed turbid yellowish fluid. Salmonella group B was identified from the cultures of blood and pleural fluid. After antimicrobial therapy and repeated therapeutic thoracentesis, the patient was improved.
Aged ; Case Report ; Empyema, Pleural/etiology+ACo- ; Female ; Human ; Salmonella Infections/drug therapy ; Salmonella Infections/complications+ACo-