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Title: Tuberculous empyema in artificial pneumothorax
Author: Smith, F. A.
Awarding Body: University of Glasgow
Current Institution: University of Glasgow
Date of Award: 1950
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The incidence of tuberculous empyema in artificial pneumothorax is reviewed. The etiology of eighty-one cases of pure and pyogenically infected empyema in seventy-eight patients is reviewed and discussed. The principal causes of empyema in this series seem to have been: 1. Choice of unsuitable cases for collapse by pneumothorax, either because of the type of disease or its acute activity at the time of induction of collapse. 2. Maintenance of unsatisfactory, ineffective or de-selective collapse due to adhesions. 3. Consequent failure to achieve cavity closure in a high percentage of cases, resulting in development of broncho-pleural fistulae. 4. Adhesion section, especially extensive cauterization of adhesions and adhesion section in the presence of pleuritis and active pleural or sub-pleural disease. 5. Maintenance of collapse after complete atelectasis had occurred. A review of treatment and survival of patients following varying forms of treatment is presented The avoidance or successful elimination of secondary pyogenic infection is the first essential in treatment. Surgical treatment in suitable cases is the treatment of choice. In cases unsuitable for surgical treatment there is some evidence to suggest that maintenance of pneumothorax is worth attempting in cases classed as satisfactorily collapsed at onset of empyema, provided sputum conversion has been obtained. The results of treatment would also appear to show that in pure tuberculous empyema, aspiration and lavage with antiseptics and dyes etc. offers no advantage over aspiration and air replacement alone. Oleothorax is prone to complications, especially the formation of chest wall sinuses. This may prevent thoracoplasty being done in a case otherwise suitable for operation.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available