CT- and ultrasound-guided catheter drainage of empyemas after chest-tube failure.
CT- and ultrasound-guided catheters were used to locate and drain empyemas in 17 patients, most of whom had failed to improve with conventional chest-tube drainage due to a poorly positioned tube. Fifteen patients (88.2%) were treated successfully, averting surgery or further drainage, and bacteremia in 1 patient was the only complication. Previously unrecognized communications with the bronchi, esophagus, and subphrenic space were demonstrated, and intracavitary tumor biopsy and instillation of a sclerosing agent were performed in several patients. Compared to the tubes used to drain abdominal abscesses, empyema catheters need less irrigation; dionosil is often the preferred contrast agent, the catheter can be withdrawn in one step, and a residual fibrotic or tumor cavity may persist after pus has been evacuated.
D000328:Adult; D000368:Aged; D002404:Catheterization / Q000379:methods*; D004322:Drainage / Q000379:methods*; D004653:Empyema / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D007440:Intubation; D008297:Male; D008875:Middle Aged; D011677:Punctures / Q000379:methods; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography