الفهرس 
Parapneumonic Pleural Effusions and EmpyemaOnly 14 pages are availabe for public view
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Abstract
Empyema and complicated pleural effusions represent common medical problems, with a mortality of up to 20%. (213) Traditionally, surgeons inserted large bore chest drains (28– 30 Fr), to achieve decompression of pleural fluid collections. Recent literature suggests that small-bore drains may be adequate, certainly for treatment of pleural effusions (213, 214), with image guidance playing an important role (215). However, the debate continues on the effectiveness of small-bore catheters in the setting of documented empyema (213, 216, 217). The role of fibrinolytic in the management of parapneumonic effusions and empyemas remained debatable. Based on early reports of efficacy, the British Thoracic Society (BTS) (218, 219), and the ACCP guidelines (220), recommend fibrinolytic drugs as management options. The aim of this work was to compare the efficacy and safety of pigtail catheter with tube thoracotomy in drainage of thoracic empyema and evaluated the therapeutic value of intrapleural instillation of streptokinase in these cases. This study was conducted on 80 patients: 43 males and 37 females at Chest Department, Tanta University Hospitals, for one year. Other sites were involved as a part of the diagnostic or therapeutic maneuvers done for patients (.Cardio-Thoracic surgery