Indications for Use of Therapeutic Pneumothorax in Lung Abscess

Abstract

IT is important in beginning this discussion to define the term “lung abscess.” As used here, it means a collection of intrapulmonary pus. It may be circumscribed or diffuse; acute or chronic; purulent or gangrenous. The etiology is equally varied. It may be (a) metastatic (pyemic). This occurs in malignant endocarditis, puerperal septicemia, suppurative periostitis, osteomyelitis, pelvic infections, otitis media with thrombosis of lateral sinus. Embolism and thrombosis of small branches of the pulmonary artery follow, with irregular areas of hemorrhagic infarcts. These soften and break down into irregular suppurating cavities. The abscess by this time is surrounded by a zone of reactive tissue, with intense congestion and edema. Such formations are frequently multiple and vary greatly in size. (b) Foreign body of organic substance produces a so-called “septic pneumonia.” This occurs in: 1. Vagus paralysis. 2. Operations on nose and throat. 3. Aneurysm or tumors in certain localities. The small areas of b...