Intrapleural Urokinase and Antibiotic Therapy for Empyema after <i>In Situ</i> Reconstruction of the Aorta and Lobectomy for Aortopulmonary Fistula due to Thoracic Aortic Aneurysm Rupture

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  • Nawata Ryosuke
    Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine
  • Suzuki Ryo
    Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine
  • Yokoyama Toshiki
    Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine
  • Tsubone Sarii
    Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine
  • Matsuno Yutaro
    Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine
  • Kurazumi Hiroshi
    Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine
  • Shirasawa Bungo
    Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine
  • Mikamo Akihito
    Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine
  • Hamano Kimikazu
    Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine

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  • 胸部大動脈瘤肺内穿破に対する<i>in-situ</i> reconstructionと肺葉切除後膿胸にUrokinaseおよび抗生剤胸腔内注入が有効であった1例

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Abstract

<p>A 62-year-old man presented with hemoptysis and hoarseness. He was diagnosed with an aortopulmonary fistula due to a thoracic aortic aneurysm rupture and was referred to our department. Emergency in-situ reconstruction of the aorta and pulmonary lobectomy were performed. Nine days postoperative, he developed empyema. Intrapleural urokinase and antibiotic therapy were selected as management instead of a video-assisted thoracoscopic debridement and decortication due to his worsening condition. The treatment was successful, and he was discharged from the hospital without any further complications. This study highlights the benefit of intrapleural administration of urokinase and antibiotics in patients with acute empyema, when surgical treatment is inappropriate.</p>

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