[Lung abscess and necrotizing pneumonia: chest tube insertion or surgery?].
Fiche publication
Date publication
avril 2012
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BERNARD Alain
Tous les auteurs :
Pages PB, Bernard A
Lien Pubmed
Résumé
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.
Référence
Rev Pneumol Clin. 2012 Apr;68(2):84-90