Differentiating empyemas and peripheral pulmonary abscesses: the value of computed tomography.

Abstract

In 13 patients, conventional radiographic techniques and clinical histories were not sufficient to determine whether a peripheral cavitary lesion was an abscess or an empyema. However, after computed tomography (CT), eight patients were diagnosed as having abscesses and five as having empyemas. Abscesses had an irregular shape and a relatively thick wall which was not uniformly wide and did not have a discrete boundary between the lesion and lung parenchyma. In contrast, empyemas had a regularly shaped lumen, a smooth inner surface, and a sharply defined border between the lesion and lung. CT studies can help to distinguish between empyemas and abscesses, and treatment can be started sooner in difficult cases.

ACR Appropriateness Criteria® Acute Respiratory Illness in Immunocompetent Patients

“…The use of intravenous contrast can increase the conspicuity of empyemas and other pleural complications. CT can also serve as a guide for pleural drainage or localization of an appropriate site for biopsy [35]. CT is the modality of choice for evaluating a persistent opacity.…”

Torakal Sivi ve Abse Drenajlari

“…Komplikasyon oranı %16, mortalite oranı %4 olup cerrahi işlemle-re göre bu oranlar oldukça düşüktür [14,18]. BT'de akciğer absesi göğüs duvarı ile akut açı-lanma gösteren, santral nekroz ve kavitasyon içeren yuvarlak intrapulmoner kitle olarak izlenir [19]. Plevra tutulumunu değerlendirmek ve drenaj kateteri yerleştirmek için güvenli bir giriş yolu belirlemede tüm hastalarda BT tetkiki yapılır.…”

Atlas of Chest Sonography

“…3.19. p8) (Baber et al 1980;Stark et al 1983). The empyema drained spontaneously by a fistula through the chest wall, surrounded by extensive inflammatory infiltrations (arrows) es (Baber et al1980;Layer et alI999).…”