Abstract: Acute Pleural empyema; Oil/Paraffin plombage
Pleural emyema is a dangerous disease. There is a chance of controlling the situation if the alarm signs are well understood:
- Multi-sided localisation.
- Not homogenous empyema because of irregular mixed cell-rich / protein-rich content.
- The tenacity of the empyema: thereby, a completely atypical distribution of trapped air content.
- The compression atelektasis with the corresponding subsequent infection threat of the lung-parenchyma. -
It is necessary to form a surgical team;The surgeon enriches us with his experience of mini-thoracotomy and pleuroscopy. The radiologist performs the decisive elements during the translation of the images in the situation as concerns the "situs.
Oleothorax, the pneumothorax-therapy and the thoracoplasty
belong to the "collapse therapies”, long-forgotten types of tuberculosis treatment.
Plombage treatment was used in the second quarter of the 20th century. Oil- or Paraffin-plombage may be summarized as "oleothorax.” In Europe paraffin was the preferred material; the preferred location was "extrapleural”, between the Fascia endothoracica and the Pleura parietalis.
Anamnesis and X-rays make the diagnosis very simple. The fatty material is – because of the period length- not so inert, as hoped. The presentation deals with the variety of complications:
sterile or infected exsudat influx in the plombage, different forms of perforation ("Paraffinomata”).
Highlights as concerns the differential diagnosis are shown:
Asbestosis, pleural Mesothelioma, Silicosis, thorax wall calcification, aspiration of contrast material.
Content:
76-80: Paraffin plombage and/or oil plombage
81-85: Early and late complications
86-90: Thoracopasty (combined with a dislocated plombage)
91-95: Pleural empyema
96-100: complication of the empyema. What are typical discoveries in pleural empyema ?
101-105: highlights as concerns the differential diagnosis
106-110: oncology, heterotopic thyroid, teratoma
111-115: Asbestosis, pleural Mesothelioma
116- 120 Silicosis; repeat the many signs of fibrothorax