VATS for Pneumopyothorax due to Ruptured Lung Abscess: A Case Report

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  • 肺膿瘍破裂による膿気胸に対して胸腔鏡下手術を行った１例

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We report a rare case of VATS for pneumopyothorax due to ruptured lung abscess. The patient was a 63-year-old man who had liver cirrhosis and diabetes mellitus (DM). He was admitted to our hospital for the control of DM. After admission, he had a cough and fever, chest CT showed a lung abscess in the left lower lobe and antibiotics were administered. Ten days after admission, the patient suddenly complained of dyspnea, and chest CT showed a left pneumopyothorax due to ruptured lung abscess. Video-assisted thoracoscopic debridement and decortication for the empyema cavity and drainage for the abscess cavity were performed. Three weeks after operation, bronchial occlusion by bronchoscopy was performed in the intractable bronchopleural fistula. Though the empyema and abscess were improved, he died due to liver failure on post operative day 48. Ruptured lung abscess is rare and may occur in patients with severe complications. We suggest that early and low invasive surgical treatment should be performed in such cases.

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