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The different treatment modalities of pyopneumothorax- Study of 50 cases

Anil Gupta, Nilesh Dutt, Naresh Patel.

Background: Pyopneumothorax is defined as a collection of pus and air in the pleural cavity. It may be localised (encapsulated) or it may involve the entire pleural cavity. In India, Pyopneumothorax with pre-existing disease is treated with antimicrobial multiple antituberculous drugs and Intercostal drainage tube or surgery.

Aims & Objective: (1) To know the age and sex incidence. (2) To study clinical presentation and characteristics of mode of onset (3) To obtain relationship with smoking. (4) To emphasise the importance of radiological and other investigations as an aid to diagnosis and management. (5) To find out the underlying lung pathology if any. (6) To decide the response to various modes of treatment. (7) To understand the complications of Pyopneumothorax.

Material and Methods: This is a progressive study of 50 Indoor patients with pyopneumothorax admitted in the civil hospital, Ahmedabad in consecutive 3 years. Traumatic pyopneumothorax patients were excluded from the Study. The response to various modes of treatment and complications were noted.

Results: The age incidences indicate that it was high in 21-30 years of age. Most common complaints were cough followed by dyspnoea and chest pain. The mycobacterium tuberculosis was the most common etiological factor. The best modality of treatment was intercostal drainage by tube with antibiotic coverage.

Conclusion: Tuberculosis is main etiology in country like India. Intercostal drainage with under water seal was the treatment of choice in most of the patients. The commonest complication following ICD was surgical emphysema.

Key words: Pyopneumothorax; Tuberculosis; Smoking; Intercostal Drainage Tube

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