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Acta Medica Iranica، جلد ۴۶، شماره ۴، صفحات ۲۹۱-۲۹۴
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عنوان انگلیسی COMPLICATED PARAPNEUNOMONIC EFFUSION: ETIOLOGY AND RESULTS OF LUNG DECORTICATION
چکیده انگلیسی مقاله Parapneunomonic effusion is a common accompaniment of bacterial pneumonia and mostly is resolved with medical management. We studied the etiology and possible underlying causes of complicated parapneumonic effusion and timing of pulmonary decortication. A descriptive study on 34 patients with postpneumonic empyema which required decortication carried out. Post surgical and post traumatic empyema were excluded. Patients' age ranged from 20 to 75 with a mean of 46 years. The most common clinical findings were fever (90%), pleural dull pain (80%), productive cough (73%) and dyspnea (70%). PPD test was negative in all patients. In 78%, white cell count was normal; in remainder it was more than 10.000. Bacteriological findings were negative and acid fast basili were not detected. All patients underwent posterolateral thoracotomy and decortication and completely expansible lung was achieved. Tissue diagnosis after decorticating showed tuberculosis in 8(24%) patients and necrotic tissue in remainder. Average medical management time and postoperative hospital stay were 38 ± 2 and 6.7 ± 2 days, respectively. Morbidity rates were acceptable and there was one late ortality. No recurrent was happened. In parapneumonic effusions not responding to standard treatment, tuberculosis must be considered, especially in addicted persons, positive family history and ESR >100. In complicated parapneumonic effusion, early thoracotomy and full decortication is recommend because it is diagnostic, allows control of infection, releases the pulmonary entrapment, early discharge from hospital, need not further antibiotic administration and is cost benefit.
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نویسندگان مقاله a داودآبادی | a davoodabadi
department of general and thoracic surgery, school of medicine, kashan university of medical science

سازمان اصلی تایید شده: دانشگاه کاشان (Kashan university)

f صدر | f sadr
department of internal medicine, school of medicine, kashan university of medical sciences, kashan,

سازمان اصلی تایید شده: دانشگاه علوم پزشکی کاشان (Kashan university of medical sciences)

e رضی | e razi
department of internal medicine, school of medicine, kashan university of medical sciences, kashan,

سازمان اصلی تایید شده: دانشگاه علوم پزشکی کاشان (Kashan university of medical sciences)

h عادلی | h adeli
department of internal medicine, school of medicine, qum university of medical sciences qum, iran
نشانی اینترنتی http://acta.tums.ac.ir/index.php/acta/article/view/3485
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