الفهرس 
Chronic pleural empyemaOnly 14 pages are availabe for public view
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Abstract
Chronic pleural empyema (CPE) is the last phase of the triphasic process of pleural empyema development. Accumulation of purulent fluid in the pleural space and thickened. Fibrous peel restricts the movement and expansion of the lung. Secondary atelectasis leads to perfusion and ventilation alteration. Gas exchange in the lung, which is the essence of respiration, is severely impaired. Para pneumonic empyema is one of the main causes of prolonged hospitalization, and approximately 50% of cases of bacterial pneumonias result in pleural effusion, with one-third developing the late fibrotic phase that leads to chronic empyema. The development of chronic disease will lead to permanent constriction by a fibrous tissue which causes stiffness of the thoracic wall and further constriction of large areas of the lung. In addition to that, residues of the empyema are responsible for general malaise and septicemia. Also, some authors reported significant reduction of oxygen uptake in the atelectatic lung, which resolved significantly after re expansion. Therefore, this condition cannot be dealt with by conservative means. This lead to the fact that lung decortication is the corner stone in management of chronic empyema. Lung decortication is a surgical procedure that involves; removal of parietal pleura, complete mobilization of lung and complete rectification of fissures, removal of fibrous peels over visceral pleura and complete suctioning of pleural space. Lung decortication is usually followed by a significant improvement in Spirometric parameters, such as vital capacity.