Management of Empyema and Bronchopleural Fistula

Abstract

Eloesser window was constructed in 8 patients with empyema and sepsis which failed to respond to more conservative measures. The empyema complicated pneumonectomy in 6 cases and was associated with bronchopleural fistula (BPF) in 4. Rapid control of the pleural space infection was obtained in all cases, allowing for further management on an outpatient basis. Closure of the fistula occurred within 4 months in 3 of 4 cases; one patient developed an oesophago-pleural fistula 31½ months later and succumbed from inanition. Spontaneous closure of the thoracostomy window with complete obliteration of pleural cavity has occurred in only 2 patients. In S others the persistent stoma with minimal drainage has been well tolerated. The Eloesser window is an acceptable method for treatment of recalcitrant empyema and BPF in our environment, with minimal morbidity and mortality.