Rabiou S, Zabeirou A, Lakranbi M, Ouadnouni Y, Smahi M. How can I treat calcified chronic pleural empyema in African context: A case report.
Int J Surg Case Rep 2024;
115:109295. [PMID:
38262219 PMCID:
PMC10830853 DOI:
10.1016/j.ijscr.2024.109295]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/25/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE
Despite the chance of a complete cure that surgery offers for patients seen early, the management of some complicated forms of chronic pyothorax with calcified pleural pockets of tuberculosis origin is risky, if not impossible. In these conditions, thoracomyoplasty with complete effacement of the pleural pocket is an effective alternative in the surgical management of these pockets.
CASE PRESENTATION
We report the case of a 37-year-old male African Arab who was treated for a chronic, calcified pleural pocket of tuberculous origin and in whom low thoracomyoplasty was performed because of the impossibility of performing a left pleuropneumonectomy. The operating courses were uneventful with full pocket closures.
REVIEW
1 year later, the patient reported having resumed his active professional life.
CLINICAL DISCUSSION
Pleural decortication associated or not with a pulmonary resection is the main surgical procedure used to manage chronic pyothorax. However, this procedure remains difficult with the risk of death, if not impossible, in cases of long-term chronicity with calcification of the pleural poche wall. In these cases, thoracomyoplasty constitutes a viable alternative in the surgical management of these pleural pockets.
CONCLUSION
In the context of tuberculosis and chronic pleural empyema, thoracomyoplasty can be an alternative with satisfactory results when performed by an experienced team using this technique.
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