title: [Lung abscess and necrotizing pneumonia: chest tube insertion or surgery?].
abstract: Lung abscesses and necrotizing pneumonia are rare complications of community-acquired pneumonia since the advent of antibiotics. Their management leans first of all on the antibiotic treatment adapted on the informed germs. However, in 11 to 20% of the cases of lung abscesses, this treatment is insufficient, and drainage, either endoscopic or percutaneous, must be envisaged. In first intention, we shall go to less invasive techniques: endoscopic or percutaneous radio-controlled. In case of failure of these techniques, a percutaneous surgical drainage by minithoracotomy will be performed. In the necrotizing pneumonia, because of the joint obstruction of the bronchus and blood vessels corresponding to a lung segment, the systemic antibiotic treatment will be poor effective. In case of failure of this one we shall propose, a percutaneous surgical drainage, especially if the necrosis limits itself to a single lobe. The surgical treatment will be reserved: in the failures of the strategy of surgical drainage, in the necroses extending in several lobes.
authors.affiliation: Service de chirurgie thoracique, hôpital du Bocage Central, CHU de Dijon, 14 rue Gaffarel, Dijon cedex, France. pb.pages@live.fr
authors.forename: P-B
authors.initials: PB
authors.lastname: Pagès
authors.forename: A
authors.initials: A
authors.lastname: Bernard
mesh_terms: D015505:Chest Tubes / Q000706:statistics & numerical data; D004322:Drainage / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D008168:Lung / Q000473:pathology* / Q000601:surgery; D008169:Lung Abscess / Q000601:surgery / Q000628:therapy*; D009336:Necrosis / Q000601:surgery / Q000628:therapy; D011014:Pneumonia / Q000601:surgery / Q000628:therapy*; D013510:Pulmonary Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data*