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Khirurgii
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Year 2011 Vol. 19 No 5

GENERAL AND SPECIAL SURGERY

V.I. PETUKHOV, M.O. RUSETSKAYA

DIAGNOSTICS OF PLEURA EMPYEMA

Objectives. To find out correlation links between the morphological structure of pleural contents and the data of the radiology diagnostics at different stages of the pleural empyema development.
Methods. Analysis of case histories of 81 patients who underwent treatment because of the pleural empyema development during the period from January 2009 to January 2011 was performed. X-ray and computer tomography of the chest organs were done in all patients.
Results. Densitometric parameters of the pleural cavity content density in the patients of the first group composed+8,5 HU (min + 6,75HU, max +10,3HU); in the second group +19 HU (min +15 HU, max +24 HU) due to the liquid, gas and organized components; in the third group +35 HU (min + 33 HU, max + 36,3 HU).
Erythrocytes, lymphocytes, macrophages, neutrophils, shadows of the destroyed cells, mesothelium cells, eosinophils, elastic fibers were determined in the cytologic examination of pleural punctate.
Connective tissue of different degrees of maturity and threads of young fibrin were revealed in the histological preparations in patients of the second group; areas of fibrous tissue with chronic inflammation and signs of aggravation were revealed in patients of the third group.
Conclusions. Computer tomography provides possibility to differentiate clearly the density of the pleural content and evaluate it in specific densitometric Hounsfield units. Complex radiology investigation of patients including densitometric parameters studying permits to evaluate the degree of pleural contents organization and consequently the process of chronization on the basis of computer tomography method before the operation.

Keywords: pleural empyema, diagnostics, X-ray, computer tomography, densitometric parameters, morphological changes
p. 78 83 of the original issue
References
  1. Koegelenberga, . Parapneumonic Pleural Effusion and Empyema / C. Koegelenberga, A. Diaconb, C. Bolligera // Respiration. 2008. Vol. 75. . 241-250.
  2. Delayed referral and gram-negative organisms increase the conversion thoracotomy rate in patients undergoing video-assisted thoracoscopic surgery for empyema / D. Lardinois [et al.] // Ann. Thorac. Surg. 2005. Vol. 79. P. 1851-1856.
  3. , . . / . . . .: , 1967. 338 .
  4. , . . / . . . .: , 1988 143 .
  5. , . . / . . , . . . .: , 1989. 512 .
  6. , . . / . . . .: , 2008. 376 .
  7. , . . / . . . .: , 2006. 188 .
  8. Sendt, W. Early thoracoscopic debridement and drainage as definite treatment for pleural empyema / W. Sendt, E. Forster, T. Hau // Eur. J. Surg. 1995. Vol. 161. . 6-10.
  9. Chronic postpneumonic pleural empyema: comparative merits of thoracoscopic versus open decortications / G. Cardillo [et al.] // Eur. J. Cardiothorac. Surg. 2009. Vol. 36. . 914-918.
  10. VATS debridement versus thoracotomy in the treatment of loculated postpneumonia empyema / A Mackinley [et al.] // Ann. Thorac. Surg. 1996. Vol. 61. . 1626-1630.
  11. Video-assisted thoracoscopic surgery for fibrinopurulent pleural empyema in 67 patients / H. Striffeler [et al.] // Ann. Thorac. Surg. 1998. Vol. 65. . 319-323.
  12. Ris, H. Video-assisted thoracoscopic surgery and open decortication for pleural empyema / H. Ris, T. Krueger // MMCTS. 2006. Vol. 109. . 273-276.
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