title: Bronchoscopic Drainage of Lung Abscesses Using a Pigtail Catheter.
abstract: BACKGROUND
  Lung abscesses are commonly treated with antibiotics. However, some patients fail to respond and may require percutaneous catheter drainage or surgical intervention. Bronchoscopic drainage (BD) of lung abscesses emerged as a therapeutic alternative in selected patients.
  
  
  OBJECTIVE
  To describe our experience with 15 patients who underwent BD at our center during 2006-2016.
  
  
  METHODS
  Patients underwent flexible bronchoscopy. Under fluoroscopic guidance, a pigtail catheter was introduced into the abscess cavity, its correct position being confirmed by the injection of contrast medium. The catheter remained in place for a few days and was flushed repeatedly with antibiotics.
  
  
  RESULTS
  Fifteen patients (9 males; median age 59 years) underwent 16 BD procedures. A pigtail catheter was successfully inserted and pus was drained from the abscess cavity in 13 procedures (81%) conducted in 12 patients, leading to rapid clinical improvement in 10 of them; resolution of fever occurred a median of 2 days (range <1-4) following pigtail insertion, and patients were discharged after 8 days (range 4-21). The pigtail catheter was extracted after a median of 4 days (range 2-6).
  
  
  CONCLUSIONS
  BD of lung abscesses was achieved in 13 out of 16 procedures, leading to rapid improvement in the majority of patients. This work adds to the existing literature in establishing this procedure as an acceptable therapeutic alternative in selected patients who fail to respond to antibiotics, especially those with an airway obstruction or a fairly central lung abscess.
authors.affiliation: Pulmonary Institute, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.
authors.forename: Avraham
authors.initials: A
authors.lastname: Unterman
authors.forename: Oren
authors.initials: O
authors.lastname: Fruchter
authors.forename: Dror
authors.initials: D
authors.lastname: Rosengarten
authors.forename: Shimon
authors.initials: S
authors.lastname: Izhakian
authors.forename: Nader
authors.initials: N
authors.lastname: Abdel-Rahman
authors.forename: Mordechai R
authors.initials: MR
authors.lastname: Kramer
mesh_terms: D000151:Acinetobacter Infections / Q000175:diagnosis / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D001999:Bronchoscopy / Q000295:instrumentation* / Q000379:methods; D057785:Catheters; D004322:Drainage / Q000295:instrumentation* / Q000379:methods; D004756:Enterobacteriaceae Infections / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000175:diagnosis / Q000601:surgery; D007902:Length of Stay; D008169:Lung Abscess / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009617:Nocardia Infections / Q000175:diagnosis / Q000601:surgery; D011030:Pneumothorax / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000601:surgery; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult