CXR: Loculated Empyema

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CXR: Loculated Empyema

  1. 1. PROF.DR. G.SUNDARAMURTHY’S UNIT – M6
  2. 2. <ul><li>60 yrs old male, k/c/o DM/ SHT/ Old CVA-Lt Hemiparesis, </li></ul><ul><li>C/o Fever X 1 month </li></ul><ul><ul><li>on & off, low grade, intermittent, chills. </li></ul></ul><ul><li>H/o Cough with expectoration X 1 month </li></ul><ul><ul><li>Scanty, not blood tinged </li></ul></ul><ul><ul><li>H/o Breathlessness – Class 2 </li></ul></ul><ul><ul><li>H/o Hiccups </li></ul></ul><ul><ul><li>H/o Night sweats </li></ul></ul>
  3. 7. Differential Diagnosis <ul><li>Hydro/Pyo pneumothorax </li></ul><ul><li>Cavitating lung cancer </li></ul><ul><li>Diaphragmatic hernia </li></ul><ul><li>Empyema </li></ul><ul><li>Other Possible DDs </li></ul><ul><li>Lung Abscess </li></ul><ul><li>TB cavity </li></ul><ul><li>Fungal – Blastomycosis </li></ul><ul><li>Infected Hydatid cyst </li></ul>
  4. 10. <ul><li>Loculated Empyema thorax Lt side with Lt Pleural effusion </li></ul><ul><li>Cholelithiasis </li></ul>CT LUNG
  5. 13. <ul><li>Stage I - “ Exudative ” </li></ul><ul><ul><ul><li>sterile pleural fluid develops secondary to inflammation without fusion of the pleura </li></ul></ul></ul><ul><li>Stage II - “ Fibrinopurulent ” </li></ul><ul><ul><ul><li>a fibrinous peel develops on both pleural surfaces limiting lung expansion </li></ul></ul></ul><ul><li>Stage III - “ Organizing ” </li></ul><ul><ul><ul><li>in-growth of capillaries & fibroblasts into the fibrinous peel </li></ul></ul></ul>Empyema Lung Accumulation of Pus in the Pleural cavity. Greek word empyein means : pus–producing (suppurates).
  6. 14. Principles of Management <ul><li>Treatment of the underlying Infection. </li></ul><ul><li>Drainage of pus from the pleura. </li></ul><ul><li>Obliteration of the space & complete Re-expansion of the Lung. </li></ul>

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