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EMPYEMA (PATHOGENESIS (spread through diaphragm (eg subphrenic abscess)…
EMPYEMA
PATHOGENESIS
spread of infection from lung to pleura
empyema compresses lung
collapse
exudate organised by irreversible fibrosis
penetrating injuries to chest wall (even a badly done chest drain)
infection via bloodstream
spread through diaphragm (eg subphrenic abscess)
direct spread from liver
ulcerative colitis with perforation
TB of small intestine
perforation of oesophagus and mediastinitis
COMPLICATIONS
pleural space filled with thick viscous pus
compression of lung - pressure collapse
extend into lung & rupture into a bronchus bronchopleural fistula (rarely discharge via skin)
replacement by granulation and fibrous tissue -> organisation
thick adhesions obliterate pleural cavity
respiratory consequences d/t adherence to chest wall
DEFINITION
collection of purulent exudates or pus in a pleural cavity