Nontuberculous Pleural Empyema in Adults: The Role of a Modified Eloesser Procedure in Its Management

Abstract

Thirty-four adults out of 109 adults and children treated for pyogenic pleural empyema at Grady Memorial Hospital underwent open drainage with segmental rib resection (a modified Eloesser procedure) during the five-year period 1965-1970. Bronchopulmonary infection was the predisposing illness in 25 of the 34 patients, and Staphylococcus aureus, coagulase positive, was the organism most frequently cultured from the empyema cavity. The Eloesser procedure was performed when the patient had a reasonably large empyema cavity with diseased underlying lung or a bronchopleural fistula or when the patient had a posteriorly located cavity which could not be drained adequately or comfortably with a chest tube. The Eloesser procedure resulted in good cosmetic, roentgenographic, and functional results in 30 patients. Three patients died in the early postoperative period, 1 from causes related and 2 from causes possibly related to the operative procedure. One patient died from an unrelated cause two months after his discharge from the hospital.