الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 53 |  |  |
| | | from | 53 | | |
Abstract
Empyema is a dynamic process defined as; pus in the pleural space due to diverse etiology. Localized or involving the entire pleural cavity; causing significant morbidity and mortality.
Preventing the progression of empyema by prompt evaluation and aggressive intervention which is the key to reduce morbidity and mortality and also the health care cost
Radiology plays two important roles in empyema management:
1) Identification and characterization of effusions.
2) Guidance for pleural aspiration or drainage.
15 patients were included in the current study, their age ranged from; five months to twelve years. The most commonly affected age group was between 1-5 years (60%).
Thirteen patients were males (86%) and two patients were females (13%) .
All of patients have fever and cough at time of presentation, while 60% were dyspenic. Mean duration of symptoms was 6 weeks.
All of patients have parapenumonic effusion, 10 cases (66.6%) had empyema on the right side of the chest and 5 cases (33.3%) had empyema on the left side.
All of the patients were managed by ultrasound guided insertion of pigtail catheter, 7 cases using 10 Fr and 8 cases using 12 Fr.
Fibrinolytic therapy started the following day and continued once daily for up to 3 days or until net drainage was less than 100 ml/day. Fibrinolytic solutions contained 20 ml of normal saline with 250,000 IU of dissolved SK (sidonase) after injection; the chest drain was flushed with 20 ml of saline and clamped for 8 hours. All patients received standardized broad-spectrum antibiotics initially that were later adjusted to the microbiological culture result.
It was found that all patients had no significant drainage (0-10 ml) after insertion of pigtail catheter. The mean value of drainage in the 1st day (100-800ml) was more than the following days (50-150 ml).
Collectively, the total amount of fluid before streptokinase injection was 5cc in average which was significantly increased to 220cc after streptokinase instillation.
We found that 13 patients have improved clinically, however; 2 patients show no clinical improvement
Duration of hospital stay for patients before injection of streptokinase ranged from 14-40 days, while duration of hospital stay in same patients after injection of streptokinase ranged from (3-10 days).
None of our patients experienced any of the known streptokinase related complications namely; fever, bleeding and allergy. The success rate of the study was 86.6 %. It was found that 2 cases need referral to surgery.