Y Refaely1, D Weissberg. 1. Department of Thoracic Surgery, Tel Aviv University Sackler School of Medicine, Israel.
Abstract
BACKGROUND: Pulmonary gangrene is a rare complication of severe lung infection with devitalization of lung parenchyma and secondary infection. If untreated, gangrene of the lung leads to sepsis, multiple-organ failure, and death. Resection of all gangrenous tissue is mandatory and is lifesaving. Pleural empyema commonly accompanies gangrene of the lung; in its presence, dissection of hilar structures for resection can lead to mediastinitis or bronchopleural fistula and should be avoided. METHODS: Three patients with pulmonary gangrene were treated in two stages: immediate fenestration first and then delayed resection of gangrenous lung in a clean field and immediate closure of the pleural window. RESULTS: Two patients underwent pneumonectomy and 1 patient, lobectomy. All patients recovered without complications. CONCLUSIONS: Creation of a pleural window (fenestration) for 1 week enables safe and curative resection of a gangrenous lung or lobe in a clean field and in a patient in stable condition.
BACKGROUND:Pulmonary gangrene is a rare complication of severe lung infection with devitalization of lung parenchyma and secondary infection. If untreated, gangrene of the lung leads to sepsis, multiple-organ failure, and death. Resection of all gangrenous tissue is mandatory and is lifesaving. Pleural empyema commonly accompanies gangrene of the lung; in its presence, dissection of hilar structures for resection can lead to mediastinitis or bronchopleural fistula and should be avoided. METHODS: Three patients with pulmonary gangrene were treated in two stages: immediate fenestration first and then delayed resection of gangrenous lung in a clean field and immediate closure of the pleural window. RESULTS: Two patients underwent pneumonectomy and 1 patient, lobectomy. All patients recovered without complications. CONCLUSIONS: Creation of a pleural window (fenestration) for 1 week enables safe and curative resection of a gangrenous lung or lobe in a clean field and in a patient in stable condition.
Authors: Beth Ann Reimel; Baiya Krishnadasen; Joseph Cuschieri; Matthew B Klein; Joel Gross; Riyad Karmy-Jones Journal: Can Respir J Date: 2006-10 Impact factor: 2.409