Case: A Massive Empyema Thoracis drained by VATS (Video Assisted Thoracoscpic Surgery)

The boy Abid, 1 and 1/2 years of age from Chittagong had fever and cough for 15 days, respiratory distress for 10 days which increases to severe degree for a day for which he was compelled to take admission in our hospital.

He was dyspnic, no cyanosis, no clubbing, H/R-160/m, R/R-80/m, temp-100◦ F, BP 90/60 mmHg.
His intercostal spaces were full, chest movement was restricted, expansibility was diminished on the right side, trachea and apex beat shifted to the left, vocal fremitus was decreased, percussion note dull, breath sound was absent and there was no added sound on the right side.

His CBC was normal, Blood culture shows no growth, X-ray shows – massive homogeneous opacity on the right side with shifting of the trachea and mediastinum on the left side.


Pleural fluid study shows- out of 4800 cell/cmm 400 are pus cells and 800 lymphocytes, sugar-28.1 mg/dl, protein-3.6 gm/dl, gram stain –gram +staphylococci , culture shows –staphylococcal aureus.




Video assisted thoracosurgery was done on 13/3/08 by our colleague Dr. Jafrul Hannan and intrathoracic tube was left for few days to clear out the accumulating pus.

Patient was given ceftriaxoneand and cloxaacillin and antibitotics.
The patient was improved and discharged on oral antibiotics.


Dr. Badrud Doza
Dr. Saiful
Dr.Fahim

link:
1) VATS
2) VATS