Percutaneous Drainage of Lung Abscess and Infected Bulla

Abstract

Background : Antibiotic therapy has proven an effective method of treatment on the majority of patients with pyogenic lung abscess and infected bulla. When medical therapy has failed, pulmonary resection is the current generally recommended therapy. But nowdays complications of percutaneous tube drainage has decreased with the use of small catheter. So we evaluated the effect of percutaneous tube drainage as an alternative therapy to the pyogenic lung abscess and infected bulla refractory to medical therapy in preference ot the pulmonary resection. Method : Nine cases of the lung abscess and three cases of infected bulla which has large cavity size over 6cm, and has underlying diseases such as lung cancer, diabetes mellitus, refractory to over 1 week of antibiotics, were performed percutaneous tube drainage with All Purpose Drainage catheter(Medi-tech, Watertown, USA) under fluoroscopy. Results : All the cases except one case which complicated empyema was improved clinically. Fever was down within 4days of percutaneous tube drainage(mean : 1.9days). Mean duration of tube drainage was 9.9days. Conclusion : Percutaneous tube drainage is an effective and relatively safe procedure in the management of lung abscesses that do not response to medical therapy. We speculate this procedure should be considered as an alternative therapy for the lung abscess refractory to medical therapy in preference to the surgery. The safety and effectiveness of this procedure in infected bulla should be evaluated with an additional study.