BibTex RIS Kaynak Göster

CT guided percutaneous catheter drainage application following inadequate tube thoracostomy of empyema cases

Yıl 2010, Cilt: 2 Sayı: 1, 8 - 13, 01.04.2010

Öz

Tube thoracostomy as a conventional therapeutic approach to empyema remains inadequate for the drainage of collections with dense septations and loculations. CT guided percutaneous drainage catheters were inserted in 11 patients to drain empyemas after conventional chest-tube drainage had been unsuccesful. Ten of the patients were treated successfully. In all patients, the empyema cavity was drained percutaneously with CT guidance. Although drainage was achieved, the empyema cavity could not be obliterated due to severe calcifi cation in one patient. Decortication surgery was performed on that patient as there was insuffi cient lung expansion. In empyema cases showing loculations, when tube thoracostomy is insuffi cient, CT guided percutaneous catheter drainage is an effective approach, which can prevent the empyema becoming chronic and reduces the need for decortication surgery.

Kaynakça

  • Mattei P, Allen JL. Treatment of empyema in children: from Hippocrates’ time to the present, and back again. Am J Respir Crit Care Med 2006; 174: 110- 111.
  • Davies O, Gleeson V. Diagnosis and management of pleural empyema. Current Opinion in Infectious Di- sease 1998; 11: 163- 168.
  • Baysal T, Bulut T, Gökirmak M, Kalkan S, Dusak A, Dogan M. Diffusion-weighted MR imaging of pleural fl uid: differentiation of transudative vs exudative pleural effusions. Eur Radiol 2004; 14: 890- 896.
  • Light RW. A new classiŞ cation of parapneumonic effusions and empyema. Chest 1995;108: 299- 301.
  • EryiĒit H, Örki A, Koēar A, Akın O, Kıral H, Ürek đ, Arman B. Plevral ampiyemlerin tedavisinde video- yardımlı torakoskopik cerrahinin rolü. Tüberküloz ve Toraks Dergisi 2007; 55: 71- 76.
  • Hamm H, Light RW. Parapneumonic effusion and empyema. Eur Respir J 1997; 10: 1150- 1156.
  • Chon KS, vanSonnenberg E, D’Agostino HB, O’Laoide RM, Colt HG, Hart E. CT-guided catheter drainage of loculated thoracic air collections in mechanically ventila- ted patients with acute respiratory distress syndrome. AJR Am J Roentgenol 1999; 173: 1345- 1350.
  • Maier A, Domej W, Anegg U, Woltsche M, Fell B, Pinter H, Smolle-Jüttner FM. Computed tomograp- hy or ultrasonically guided pigtail catheter drainage in multiloculated pleural empyema: a recommended procedure? Respirology 2000; 5: 119- 124.
  • Merriam MA, Cronan JJ, Dorfman GS, Lambiase RE, Haas RA. Radiographically guided percutaneous catheter drainage of pleural fl uid collections. AJR Am J Roentgenol 1988; 151: 1113- 1116.
  • Light RW. Parapneumonic effusions and empyema. Proc Am Thorac Soc 2006; 3: 75-80.
  • Topal U, Sahin N, Gökalp G, Gebitekin C. In- trathoracic textilomas: radiologic Ş ndings Tani Girisim Radyol 2004; 10: 280- 283.
  • Tattersall DJ, Traill ZC, Gleeson FV. Chest drains: does size matter? Clin Radiol 2000; 55: 415- 421.
  • Keeling AN, Leong S, Logan PM, Lee MJ. Empye- ma and effusion: outcome of image-guided small-bore catheter drainage. Cardiovasc Intervent Radiol 2008; 31: 135- 141.
  • Marom EM, Palmer SM, Erasmus JJ, Herndon JE, Zhang C, McAdams HP. Pleural effusions in lung transplant recipients: image-guided small-bore catheter drainage. Radiology 2003; 228: 241- 245.
  • Cochran JB, Tecklenburg FW, Turner RB. Intrap- leural instillation of Ş brinolytic agents for treatment of pleural empyema. Pediatr Crit Care Med 2003; 4: 39- 43.

Toraks Tüpünün Yetersiz Kaldığı Ampiyemli Olgularda BT Eşliğinde Perkütan Kateter Drenaj Uygulaması

Yıl 2010, Cilt: 2 Sayı: 1, 8 - 13, 01.04.2010

Öz

Ampiyemin konvansiyonel tedavi yöntemi olan tüp torakostomi, özellikle yoğun septasyonlar ve lokülasyonlar içeren kolleksiyonların drene edilmesinde yetersiz kalmaktadır. Göğüs tüpünün yetersiz kaldığı, ampiyemli 11 olguya BT eşliğinde perkütan kateter drenaj uygulandı. Olguların 10 unda başarılı drenaj sağlandı. Tüm hastalarda ampiyem poşu, BT eşliğinde perkütan drene edildi. Bir olguda yoğun kalsifi kasyon nedeniyle drenaj sağlanmasına rağmen ampiyem poşu oblitere edilemedi. Akciğerin yetersiz ekspansiyonu nedeniyle, olguya cerrahi dekortikasyon uygulandı. Tüp torakostominin yetersiz kaldığı, lokülasyonlar gösteren ampiyem olgularında, BT eşliğinde perkütan kateter drenaj uygulaması, ampiyemin kronikleşmesini önleyerek açık cerrahi dekortikasyon ihtiyacını azaltan etkin bir tedavi yöntemdir.

Kaynakça

  • Mattei P, Allen JL. Treatment of empyema in children: from Hippocrates’ time to the present, and back again. Am J Respir Crit Care Med 2006; 174: 110- 111.
  • Davies O, Gleeson V. Diagnosis and management of pleural empyema. Current Opinion in Infectious Di- sease 1998; 11: 163- 168.
  • Baysal T, Bulut T, Gökirmak M, Kalkan S, Dusak A, Dogan M. Diffusion-weighted MR imaging of pleural fl uid: differentiation of transudative vs exudative pleural effusions. Eur Radiol 2004; 14: 890- 896.
  • Light RW. A new classiŞ cation of parapneumonic effusions and empyema. Chest 1995;108: 299- 301.
  • EryiĒit H, Örki A, Koēar A, Akın O, Kıral H, Ürek đ, Arman B. Plevral ampiyemlerin tedavisinde video- yardımlı torakoskopik cerrahinin rolü. Tüberküloz ve Toraks Dergisi 2007; 55: 71- 76.
  • Hamm H, Light RW. Parapneumonic effusion and empyema. Eur Respir J 1997; 10: 1150- 1156.
  • Chon KS, vanSonnenberg E, D’Agostino HB, O’Laoide RM, Colt HG, Hart E. CT-guided catheter drainage of loculated thoracic air collections in mechanically ventila- ted patients with acute respiratory distress syndrome. AJR Am J Roentgenol 1999; 173: 1345- 1350.
  • Maier A, Domej W, Anegg U, Woltsche M, Fell B, Pinter H, Smolle-Jüttner FM. Computed tomograp- hy or ultrasonically guided pigtail catheter drainage in multiloculated pleural empyema: a recommended procedure? Respirology 2000; 5: 119- 124.
  • Merriam MA, Cronan JJ, Dorfman GS, Lambiase RE, Haas RA. Radiographically guided percutaneous catheter drainage of pleural fl uid collections. AJR Am J Roentgenol 1988; 151: 1113- 1116.
  • Light RW. Parapneumonic effusions and empyema. Proc Am Thorac Soc 2006; 3: 75-80.
  • Topal U, Sahin N, Gökalp G, Gebitekin C. In- trathoracic textilomas: radiologic Ş ndings Tani Girisim Radyol 2004; 10: 280- 283.
  • Tattersall DJ, Traill ZC, Gleeson FV. Chest drains: does size matter? Clin Radiol 2000; 55: 415- 421.
  • Keeling AN, Leong S, Logan PM, Lee MJ. Empye- ma and effusion: outcome of image-guided small-bore catheter drainage. Cardiovasc Intervent Radiol 2008; 31: 135- 141.
  • Marom EM, Palmer SM, Erasmus JJ, Herndon JE, Zhang C, McAdams HP. Pleural effusions in lung transplant recipients: image-guided small-bore catheter drainage. Radiology 2003; 228: 241- 245.
  • Cochran JB, Tecklenburg FW, Turner RB. Intrap- leural instillation of Ş brinolytic agents for treatment of pleural empyema. Pediatr Crit Care Med 2003; 4: 39- 43.
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Makalesi
Yazarlar

Abdurrahim Dusak Bu kişi benim

Gökhan Gökalp Bu kişi benim

Metin Doğan Bu kişi benim

Tamer Baysal Bu kişi benim

Yayımlanma Tarihi 1 Nisan 2010
Yayımlandığı Sayı Yıl 2010 Cilt: 2 Sayı: 1

Kaynak Göster

Vancouver Dusak A, Gökalp G, Doğan M, Baysal T. Toraks Tüpünün Yetersiz Kaldığı Ampiyemli Olgularda BT Eşliğinde Perkütan Kateter Drenaj Uygulaması. Maltepe tıp derg. 2010;2(1):8-13.