Thoracic surgical problems associated with rheumatoid arthritis.

Nine cases are presented that represent nearly all of the pleural, lung, and pericardial manifestations of rheumatoid arthritis. Three of the 9 had lung biopsies for various reasons to confirm the presence of the rheumatoid change. Six patients had complications of the disorder that required thoracic surgical intervention. The operations included emergency exploration of an empyema cavity for hemorrhage, decortication of the heart and lung, permanent open empyema drainage, and tube thoracostomy. The fact that all of the patients withstood the major complications and major surgery proves that patients with severe rheumatoid disease can withstand major thoracic surgery whenever there occurs a problem that will further increase their disability or threaten their lives.