Percutaneous catheter drainage for acute empyema. Improved cure rate using CAT scan, fluoroscopy, and pigtail drainage catheters.

Percutaneously inserted pigtail nephrostomy catheters were used to treat empyemas in 12 patients. Thoracic computed tomographic (CT) scan and fluoroscopy were used to localize precisely and place the catheters into loculated collections of fluid. Percutaneous catheter drainage (PCD) of empyema was successful in seven of seven patients (100%) in whom standard tube thoracostomy (STT) had initially failed and in three of five patients (60%) who had PCD as the initial drainage procedure. Overall, PCD was successful in treating empyema in ten of 12 patients (83%). The procedure was well tolerated and there were no complications. PCD is a safe and effective method for drainage of loculated empyemas as the initial procedure or after STT has failed.