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Lung India Official publication of Indian Chest Society  
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Year : 1998  |  Volume : 16  |  Issue : 2  |  Page : 56-59

Successful Management Of Tubercular Bronchopleural Fistula With Pyopneumothorax By Saline Irrigation



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D Rosha


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A study was conducted to investigate if regular saline irrigation in patients with tubercular bronchopleural fistula (BPF) and pyopneumathorax (PPT) could achieve healing, when administered as an adjunct to first line anti-tubercular treatment. The study group consisted of 14 patients (8 females and 6 males) with ages ranging between 12-46 years. All were sputum positive pulmonary tuberculosis patients and were considered to be unfit for major surgery. In three patients, the BPF healed during the first month of observation period. The remaining 11 patients were treated with the conventional chest tube in the mid-axillary line and additional catheter inserted into the lower most point of the empyema. Daily saline irrigation through the catheter was performed in each patient. The bronchopleural fistula closed in 10 patients after a mean of 35 days (range 49-105 days). One patient refused further irrigation after 32 days. Sequelae following the procedure were fibrothorax in five, hydrothorax in three, and pneumothorax in two. There were seven patients (four males and three females) who were studied as controls. These were patients admitted consecutively in the hospital with a diagnosis of BPF and PPT during a period of one year just prior to the commencement of this study and were treated with conventional chest tube drainage and anti-tubercular treatment. There was healing of bronchopleural fistula and raexpansion of lung in two patients of the control group. In addition, three patients died and two patients did not report for follow up after four and seven months respectively in the control group.


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