Abstract

Empyema is the accumulation of pyogenic effusion in the sterile pleural space following infections of intrathoracic or extrathoracic origin that are caused by different microorganisms. Although it is most commonly encountered during or following pneumonia, it can also be due to traumatic and postoperative causes as well as specific infections of the pleural region. Although several treatment methods have been defined for parapneumonic empyemas, the main objective is to control the infection as early as possible while eliminating the pyogenic material by effective drainage in an attempt to make the pulmonary reexpansion possible. Basic procedures for drainage are repetitive thoracentesis and tube thoracostomy. In order to achieve chemical debridement during drainage, intrapleural fibrinolytic agents can be utilized. For ensuring an effective a sufficient drainage, evaluation with video-assisted thoracoscopic technique and placement of a tube is being recommended in recent years. If sufficient expansion cannot be achieved with drainage procedures and pulmonary physiology deteriorates due to fibrothorax, decortication procedures are implemented.