Lungenabszesse und Bronchiektasen [Pulmonary abscesses and bronchiectasis]

Détails

ID Serval
serval:BIB_12360
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Lungenabszesse und Bronchiektasen [Pulmonary abscesses and bronchiectasis]
Périodique
Schweizerische Medizinische Wochenschrift
Auteur(s)
Ris H.B., Stocker J.M., Im Hof V.
ISSN
0036-7672
Statut éditorial
Publié
Date de publication
1999
Volume
129
Numéro
14
Pages
547-555
Langue
allemand
Notes
Publication types: English Abstract ; Journal Article ; Review Publication Status: ppublish
Résumé
Both primary and secondary pulmonary abscesses are increasingly observed in thoracic surgery units. Primary pulmonary abscesses are related to necrotising pneumonia or aspiration due to alcoholism, drug abuse, dysphagia or gastrointestinal reflux disease. Secondary poststenotic abscesses are related to bronchial obstruction (endobronchial tumour or foreign body aspiration) or to superinfection of pulmonary neoplasia or infarction pneumonia. Bronchoscopy is mandatory if a pulmonary abscess is suspected, to exclude endobronchial obstruction and obtain bacteriological examination by bronchial lavage or transbronchial fine needle aspiration. Transthoracic fine needle aspiration may be helpful for bacteriological examination, since germs found in sputum do not necessarily correlate with those found in the abscess. Pulmonary abscesses are primarily treated by administration of appropriate antibiotics with a remission rate of 80%. In the presence of complications of the abscess or if conservative management fails, percutaneous transthoracic drainage or surgical resection may be indicated. Bronchiectasis is also increasingly seen, especially in refugees and immigrants. The disease is characterised by chronic dilatation of bronchi with paroxysmal cough, mucopurulent secretion and recurrent pulmonary infections. Bronchiectasis is most commonly caused by recurrent bronchial infections during childhood or behind bronchial obstruction. Congenital bronchiectasis is very rare. Viral and bacterial pulmonary infections during childhood are by far the most common causes of bronchiectasis, leading to destruction of the mucociliary apparatus and the cartilage of the segmental bronchi. Bronchiectasis should be treated by an appropriate antibiotic regimen. Resection should only be considered in situations where a conservative regimen fails. Segmentectomy of all involved segments is the surgical treatment of choice in situations with well-localised bronchiectasis and results in long-lasting remission in over 80% of those patients. Patients with bilateral bronchiectasis may be considered for bilateral surgical resection if diffuse and congenital disease has been ruled out.
Mots-clé
Adult, Aged, Bronchiectasis/drug therapy, Bronchiectasis/surgery, Humans, Lung Abscess/drug therapy, Lung Abscess/surgery, Middle Aged
Pubmed
Web of science
Création de la notice
19/11/2007 13:03
Dernière modification de la notice
20/08/2019 13:40
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