A case report of open-window thoracotomy and thoracomyoplasty for empyema

We report a case of empyema successfully treated by two-procedure operation. An 80-year-old male with a complaint of continuous fever was suspected of pyelonephritis and admitted to another hospital. However, fever continued after antibiotics therapy. Chest CT showed a low density area (10×6cm) in the left posterior intrathoracic space, and the patient was referred to our hospital for treatment of empyema in September 2002. Chest tube drainage was immediately performed, and discharge culture showed Escherichia coli. Openwindow thoracotomy was performed because pleural effusion did not change to clear in spite of washing through the drainage tube. Chest wall reconstruction was performed with an omental flap and myocutaneous flap of the latissimus dorsi on the 36th postoperative day. The patient's postoperative course was good. Two-procedure operation was an effective technique, for empyema with refractory pleural effusion.