Management of Lung Abscess With Percutaneous Catheter Drainage

Abstract

Percutaneous catheter drainage was used to treat 12 among 34 cases of lung abscesses, who were refractory to medical therapy, severely ill and high risk cases for surgery. A complete clinical and radiological recovery was achieved in all the cases who underwent catheter drainage, thereby obviating the need for surgery. None of the cases had catheter or procedures related complications. From this study it is inferred that percutaneous transthoracic catheter drainage is a safe and an effective modality of therapy for patients with lung abscess in whom medical therapy has failed and those who are unsuitable for surgery. MJAFI 1998; 54: 134-136

Unusual case of a giant lung abscess initially misdiagnosed and treated as an empyema

“…Percutaneous catheter drainage may be an alternative to surgery in these patients. Several case reports and series support its efficacy and safety, with lower morbidity and mortality than surgical resection, even in those with high surgical risk,1 6 8 17 19–21 presenting an overall success rate up to 84%, a complication rate of 16% and associated mortality up to 4.8% 17 19–21…”

“…Surgical resection is the recommended approach in the 10%–15% of patients who fail to respond to conservative treatment 1–3 19. However, not all patients are suitable for surgery, which still carries considerable morbidity and mortality, ranging from 11% to 16% 8 19–21. Percutaneous catheter drainage may be an alternative to surgery in these patients.…”

“…This procedure can be performed effectively and safely under image guidance,6 19–21 or as a bedside non–image-guided procedure in suitable patients17 20–22 : those with abscesses larger than 4 cm in diameter, pleural based and at least within 2 weeks of onset. In these cases, there is always symphysis of pleura overlying the abscess and the chest wall, minimising the risk of complications 17.…”

“…In most case series, percutaneous tube drainage was used in the management of lung abscesses refractory to medical therapy 3 6 17 19–21. Nevertheless, some authors showed both efficacy and safety of this procedure as the primary treatment of lung abscesses in combination with antibiotics in cases of sepsis, deteriorating patient condition, conditions associated with a high mortality rate19 and in the management of giant lung abscesses 22…”

Percutaneous catheter drainage of a pyogenic lung abscess: A case report

“…The technique for percutaneous catheter drainage of pyogenic abscesses is well described in the literature. [1] The clinical condition of the patient improved within the next 72 hours, temperatures settled within 48 hours of drainage, while her heart rate normalised (to <90 bpm) after 72 hours. The patient remained in the ward for a further 7 days and was discharged in a stable condition.…”