Empyema

Empyema is a condition in which purulent fluid accumulates within the pleural cavity. Empyema lasting less than three weeks is called acute empyema, between three weeks and three months is called subacute empyema, and lasting more than three months is called chronic empyema. Initial symptoms include fever, chest pain, and cough. As the illness continues, a scab-like substance (fibrin) accumulates within the pleural cavity, forming septa within the cavity and a fibrin membrane on the surface of the lung. This thickened fibrin membrane inhibits lung expansion. Furthermore, when holes (fistulas) form between the bronchi and lungs, this condition is called empyema with a fistula, and can be complicated by purulent sputum and pneumonia.

Our treatment policy

Empyema is a respiratory infection that requires surgical treatment in collaboration with respiratory medicine. In acute empyema, early chest drainage and effective antibiotic administration are essential to ensure adequate lung re-expansion. However, if a fibrin septum forms in the empyema cavity and drainage is ineffective, thoracoscopic empyema dissection is performed to achieve early treatment. For chronic empyema, various surgical procedures are performed appropriately depending on the condition. If adequate lung re-expansion is expected, decortication is performed to remove the thickened membrane on the lung surface. If sufficient re-expansion is not expected, muscle packing or thoracoplasty is performed. In cases of empyema with a fistula, where a hole (fistula) has formed between the bronchus and lung, a fenestration procedure is performed, followed by muscle packing or omental packing, depending on the condition.

Number of cases per year