During the past 10 years 114 patients with empyema have been treated in hospital of Chonnam University. There were 87 males and 27 females ranging from 20 days to 70 years of age.
The etiology was pyogenic pneumonia in 36.7%, tuberculosis in 22.7%, paragonimiasis in 8.8%, post-thoracotomy in 5.4%, post-trauma in 4.4%, lung abscess in 3.5%, malignancy in 3.5%, post-esophageal operation in 1.8%, and sterile in 10.5%.
The over-all mortality rate was 2% (3 patients). The majority of deaths occured in patients with associated systemic illness (liver cirrhosis in I, and renal tuberculosis in 1) and resistant tuberculosis for anti-tuberculosis drugs in one patient.
Adequate drainage and obliteration of the pleural space continues to be the most important aspect of treatment and can frequently be achieved by closed chest tube thoracostomy in acute empyema especially in children. The more chronic thick-walled or loculated cavities require open drainage (open window theraphy), decortication, thoracoplasty, sterilization, and myoplasty for closure of tracheobronchial fistula.
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