Case report
Bismuth Paste Injection for Empyema Thoracis: A 100-Year-Old Method Revisited

https://doi.org/10.1016/j.athoracsur.2010.02.031Get rights and content

Bismuth paste injection into the pleural cavity used to be a treatment for chronic empyema thoracis. This method, however, was long forgotten and scarcely practiced due to advanced surgical techniques and antibiotic therapy. We report a 50-year-old man with chronic empyema thoracis who was successfully treated with bismuth paste injection after a failed surgical decortication and a long-term chest drainage. This case highlights a trial of a 100-year-old method of bismuth paste injection which proved effective after standard measures had failed.

Section snippets

Comment

It is a common practice to insert a chest tube for drainage as the initial treatment for empyema thoracis, followed by an antibiotic therapy and aggressive respiratory physiotherapy with postural drainage. In some cases, decortication with pleurectomy or, rarely, thoracoplasty may be required as a more definitive treatment. A repeat surgical procedure is not uncommon. Reaccumulation of the pus into an unhealed pleural cavity will recur in many cases once the chest tube is removed.

References (3)

There are more references available in the full text version of this article.

Cited by (1)

  • Image-Guided Palliative Care Procedures

    2011, Surgical Clinics of North America
    Citation Excerpt :

    Standard surgical therapy, decortication, muscle/omental flap transposition (plombage), and thoracoplasty are all too morbid for frail patients. In cases of chronic empyema thoracis, bismuth paste plombage may be an effective treatment,119 but this does not treat the patient’s dyspnea. Alternatively, if the lung expands fully after thoracentesis, clinicians have the option of a long-term tunneled chest drain or chemical pleurodesis to prevent recurrence of the pleural effusion.

View full text