Gangrene of the lung: treatment in two stages.
BACKGROUND
Pulmonary gangrene is a rare complication of severe lung infection with devitalization of lung parenchyma and secondary infection. If untreated, gangrene of the lung leads to sepsis, multiple-organ failure, and death. Resection of all gangrenous tissue is mandatory and is lifesaving. Pleural empyema commonly accompanies gangrene of the lung; in its presence, dissection of hilar structures for resection can lead to mediastinitis or bronchopleural fistula and should be avoided.


METHODS
Three patients with pulmonary gangrene were treated in two stages: immediate fenestration first and then delayed resection of gangrenous lung in a clean field and immediate closure of the pleural window.


RESULTS
Two patients underwent pneumonectomy and 1 patient, lobectomy. All patients recovered without complications.


CONCLUSIONS
Creation of a pleural window (fenestration) for 1 week enables safe and curative resection of a gangrenous lung or lobe in a clean field and in a patient in stable condition.
Refaely
Y
Y
Department of Thoracic Surgery, Tel Aviv University Sackler School of Medicine, Israel.
Weissberg
D
D
D000328:Adult; D001228:Aspergillosis / Q000150:complications / Q000601:surgery; D004322:Drainage; D016724:Empyema, Pleural / Q000150:complications / Q000601:surgery; D005260:Female; D005734:Gangrene / Q000209:etiology / Q000601:surgery; D006801:Humans; D008168:Lung / Q000473:pathology* / Q000601:surgery; D008169:Lung Abscess / Q000150:complications / Q000601:surgery*; D008297:Male; D011013:Pneumonectomy; D011014:Pneumonia / Q000150:complications / Q000601:surgery