ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
HYDROPNEUMOTHORAX IN PATIENTS WITH ACTIVE PULMONARY TUBERCULOSIS
Zafer Kartaloğlu, Oğuzhan Okutan, *Turgut Işıtmangil, Erdoğan Kunter, *Şaban Sebit, Murat Apaydın, Ahmet İlvan
GATA Haydarpaşa Eğitim Hastanesi, Göğüs Hastalıkları Kliniği,İstanbul
*GATA Haydarpaşa Eğitim Hastanesi, Göğüs Cerrahisi Kliniği,İstanbul
Background: Hydropneumothorax (HPT) is a complication of pulmonary tuberculosis (TB) and cause significant morbidity. In this study, we aimed evaluation of our patients with active TB and HPT.

Methods: We reviewed retrospectively 17 cases of hydropneumothorax associated with active pulmonary tuberculosis, from January 1998 to December 2002. There were 14 male and three female, and mean age of patients was of 23.8 ± (range 20 to 52) years. Eleven patients had HPT during admission to hospital and, six patients had after starting antituberculosis treatment. The HPT was right-sided in 12, left-sided in five patients. One patient also had a cutaneous fistula. Radiologically one patient had mild, five moderate and 11 far advanced disease. Six patients had cavities on the chest x-ray. One patient had miliary tuberculosis. Pleural fluid LDH level was 1767 ± 944 U/L, pleural fluid protein level 5.2 ± 1.4 g/dL and, pleural fluid glucose 31.7 ± 22.6 mg/dL in 14 patients that performed analysis of pleural fluid. M. tuberculosis was detected in the pleural effusion of three patients.

Results: All patients were treated with chest tube drainage and chemotherapy. The duration of chest tube drainage was longer in cases those were performed open drainage (p = 0.014). Intrapleural fibrinolytic agents or irrigation was not performed. At the end of the treatment period pleural thickening developed in 10 patients and, four of them underwent decortications. Also, one of them required pneumonectomy. The pleural thickening was related to the level of pleural fluid glucose (p = 0.04).

Conclusions: In countries where tuberculosis prevalence is high one must be aware of the HPT complication and adequate chemotherapy and drainage must be duly performed. Also, when necessary surgery must be performed without delay.

Keywords : Tuberculosis, empyema, pneumothorax, hydrothorax, pyothorax
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