Fritz J. Baumgartner

The management of empyema can be a difficult and often confusing subject. There are several fundamental questions that must be answered (Table 13.1). Is it acute or chronic? Is there a space problem which requires obliteration? Is there a bronchopleural fistula? Is this a postoperative problem? The individual management depends on the answers to these questions.

The etiology of empyema is most commonly a result of lung abscess or pneumonia. The second most common etiology is post-surgical after lobectomy or pneumonectomy. Other causes include spontaneous pneumothorax, retained foreign body, or a subdiaphragmatic process causing supradiaphragmatic empyema.

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