Abdurrahim DUSAK, Gökhan GÖKALP, Metin DOĞAN, Tamer BAYSAL

Toraks Tüpünün Yetersiz Kaldığı Ampiyemli Olgularda BT Eşliğinde Perkütan Kateter Drenaj Uygulaması

Ampiyemin konvansiyonel tedavi yöntemi olan tüp torakostomi, özellikle yoğun septasyonlar ve lokülasyonlar içeren kolleksiyonların drene edilmesinde yetersiz kalmaktadır. Göğüs tüpünün yetersiz kaldığı, ampiyemli 11 olguya BT eşliğinde perkütan kateter drenaj uygulandı. Olguların 10 unda başarılı drenaj sağlandı. Tüm hastalarda ampiyem poşu, BT eşliğinde perkütan drene edildi. Bir olguda yoğun kalsifi kasyon nedeniyle drenaj sağlanmasına rağmen ampiyem poşu oblitere edilemedi. Akciğerin yetersiz ekspansiyonu nedeniyle, olguya cerrahi dekortikasyon uygulandı. Tüp torakostominin yetersiz kaldığı, lokülasyonlar gösteren ampiyem olgularında, BT eşliğinde perkütan kateter drenaj uygulaması, ampiyemin kronikleşmesini önleyerek açık cerrahi dekortikasyon ihtiyacını azaltan etkin bir tedavi yöntemdir.

Anahtar Kelimeler:

ampiyem, tüp torakostomi, BT eşliğinde, perkütan kateter drenaj

CT guided percutaneous catheter drainage application following inadequate tube thoracostomy of empyema cases

Tube thoracostomy as a conventional therapeutic approach to empyema remains inadequate for the drainage of collections with dense septations and loculations. CT guided percutaneous drainage catheters were inserted in 11 patients to drain empyemas after conventional chest-tube drainage had been unsuccesful. Ten of the patients were treated successfully. In all patients, the empyema cavity was drained percutaneously with CT guidance. Although drainage was achieved, the empyema cavity could not be obliterated due to severe calcifi cation in one patient. Decortication surgery was performed on that patient as there was insuffi cient lung expansion. In empyema cases showing loculations, when tube thoracostomy is insuffi cient, CT guided percutaneous catheter drainage is an effective approach, which can prevent the empyema becoming chronic and reduces the need for decortication surgery.

Keywords:

empyema, tube thoracostomy, CT guided, percutanous catheter drainage,

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