Acute bronchiectatic abscesses simulating empyema

• Published in: The Journal of pediatrics Vol. 14; no. 5; pp. 661 - 670
• Main Author: Shaw, Robert R.
• Format: Journal Article
• Language: English
• Published: Mosby, Inc 01.05.1939
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(39)80157-3

Obstructive emphysema in acute respiratory disease in infants is reviewed. Three cases are presented in which bronchial infection superimposed on obstructive emphysema led to an erroneous diagnosis of empyema. In two cases, thoracotomy was performed before the pulmonary condition was recognized. The theory is proposed that bronchial infection, superimposed on obstructive emphysema, may be the pathologic physiologic factor in the etiology of certain cases of bronchiectasis. Roentgen films showing bronchi containing air in the periphery of the lung should suggest that the infection may be entirely intrapulmonary. A thoracotomy with rib resection will, however, usually be necessary to rule out empyema. Intrabronchial suction is advocated in all cases of severe obstructive emphysema since improved bronchial drainage is most important in cases in which the emphysematous lung has become filled with secretions.