CT- and ultrasound-guided catheter drainage of empyemas after chest-tube failure.

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Abstract
CT [computed tomography] and ultrasound-guided catheters were used to locate and drain empyemas in 17 patients, most of whom had failed to improve with conventional chest-tube drainage due to a poorly positioned tube. Fifteen patients (88.2%) were treated successfully, averting surgery or further drainge and bacteremia in 1 patient was the only complication. Previously unrecognized communications with the bronchi, esophagus and subphrenic space were demonstrated and intracavitary tumor biopsy and instillation of a sclerosing agent were performed in several patients. Compared to the tubes used to drain abdominal abscesses, empyema catheters need less irrigation; dionosil is often the preferred contrast agent, the catheter can be withdrawn in 1 step, and a residual fibrotic or tumor cavity may persist after pus has been evacuated.