Thoracic Empyema due to Gunshot Wounds Successfully Treated with Fenestration in a Low-resource Setting—A Case Report

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 81; no. 3; pp. 445 - 448
• Main Authors: SEKI, Satoshi, IRIE, Takumi, YAMAZAKI, Shigeru
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2020
• Subjects: empyema; gunshot wound; thoracic fenestration
• DOI: 10.3919/jjsa.81.445
• ISSN: 1345-2843

A 25-year-old woman in the northern region of South Sudan was shot on the roadside and transported to a hospital for treatment of gunshot wounds in the chest and abdominal regions. Laparotomy and left chest tube insertion were performed. The gunshot exit wound on the chest wall was closed. Thoracic empyema was noted on hospitalization day 10 ; drainage via the chest tube and continued antibiotic treatment did not produce improvement. After fenestration to the left chest on hospitalization day 17, the patient recovered and was discharged on hospitalization day 31. As the hospital and operating theater settings were not equipped with ventilators and only had oxygen of low concentration, it was difficult to decide whether fenestration should be performed or not. However, if normal drainage is insufficient, fenestration for thoracic empyema may be a valid option in low-resource settings.