Current aspects of diagnostics and surgical treatment of acute lung abscesses

Authors

DOI:

https://doi.org/10.14739/2310-1210.2021.4.224124

Keywords:

lung abscess, ultrasonic imaging, computed tomography, thoracoscopy, thoracic surgical procedure

Abstract

Increasing number of lung diseases, unfavorable environmental factors, dissemination of infectious agents in a patient's body result in increased frequency of purulent-septic complications, thereby making the study on methods of their diagnosis and treatment relevant.

Aim of the work: to examine the diagnostic value of lung ultrasound (US) and spiral computed tomography (SCT) in the diagnosis of acute abscesses and in determining the tactics of surgical treatment.

Materials and methods. A prospective study of 40 cases of acute lung abscesses with diagnostic value of US and SCT examination to choose a surgical method in accordance with the type of acute lung abscess.

Results. Male was dominated in the study (82.5 %). The median age was 52 (43.5; 60.0) years. SCT revealed an abscess with sequestration in 9 (22.5 %) of 40 patients, which was confirmed during surgery. A false negative result was obtained in 5 (35.7 %) patients out of 14. Lung US revealed sequestration in 14 (35.0 %) patients: 2 (14.3 %) of them were false positive. Transthoracic drainage was performed in 24 (92.3 %) of 26 patients without sequestration. In 2 (7.7 %) cases – video abscessoscopy (VAS). The median length of hospital stay was 34.5 (29.0; 43.0) days for patients without sequestration and 32.0 (26.0; 35.0) – with sequestration, Р = 0.16.

Conclusions. Modern radiation imaging is an effective tool for the diagnosis of lung abscess. The sensitivity and specificity of computed tomography was 64.3 % and 100.0 %, sonography – 85.7 % and 92.3 %, respectively, in the study. The concurrent use of these diagnostic methods increases their information content: sensitivity up to 100.0 %, specificity up to 92.3 %. Video abscessoscopy with sequestrectomy is an effective method of treatment and etiological diagnosis of the process, which allows achieving the length of hospital stay comparable to patients without sequestration: 32.0 (26.0; 35.0) vs 34.5 (29.0; 43.0), Р = 0.16.

Author Biographies

Ya. V. Tielushko, Zaporizhzhia State Medical University, Ukraine

MD, PhD, Associate Professor of the  Department of  Disaster Medicine, Military Medicine and Neurosurgery

V. I. Pertsov, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor, Head of the Department of Disaster Medicine, Military Medicine and Neurosurgery

S. I. Savchenko, Zaporizhzhia State Medical University, Ukraine

MD, PhD, Assistant of Department of Disaster Medicine, Military Medicine and Neurosurgery

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Published

2021-07-01

How to Cite

1.
Tielushko YV, Pertsov VI, Savchenko SI. Current aspects of diagnostics and surgical treatment of acute lung abscesses. Zaporozhye Medical Journal [Internet]. 2021Jul.1 [cited 2024Jun.22];23(4):524-30. Available from: http://zmj.zsmu.edu.ua/article/view/224124

Issue

Section

Original research