| A clinical study of cavitary lesions on nondependent region. |
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Soo Nam Moon1, Do Jin Kim1, Ki Up Kim1, Sang Moo Lee1, Hyeon Tae Kim1, Soo Taek Uh1, Yong Hoon Kim1, Choon Sik Park1, Yeon Tae Chung2 |
1Derartment of Internal Medicine, Collge of Medicine, Soonchunhyang University, Seoul, Korea
2Department of Internal Medicine, National Medical Center, Seoul, Korea |
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| Abstract |
Background
The lung abscess predominantly occurs on a dependent region, because its major predisposing factor is aspiration. However, a lung abscess appeared on a nondependent region occasionally. Traditionally bronchoscopy has been performed in patients with lung abscess on a nondependent region for evaluating the endobronchial obstruction such as bronchogenic carcinoma.
But the clinical characteristics and necessities of bronchoscopy in patients with lung abscess located at nondependent region have not been discussed previously. Thus, we investigated the underlying etiologies and the necessities of bronchoscopy in patients with Jung abscess in a nondependent region.
Method
Fifteen patients with cavitary Jesion on a nondependent location have been studied retrospectively by reviewing their clinical records, chest P As, computerized tomograms, and bronchoscopic findings.
Results
1) Most patients were older than 30 years except one, and their mean age was 51 years. The ratio of male to female was 6.5:1.
2) The underlying etiologies were bacterial infections in 13 cases, and tuberculous infection in two cases. However, bronchogenic carcinoma was not found as its etiology.
3) Among thirteen bacterial lung abcess, tweleve cases located at right middle lobe 4) The findings of bronchoscopy were non-speicifc mucosal change in 8 cases and segmental obstructions in 2 cases. There were no malignant evidences in the finings of cytology and bronchscopic biopsy.
5) Among thirteen bacterial lung abcess, eleven patients showed good clinical response to antibiotic therapy.
Conclusion
The necessity of early bronchoscopy may need to be re-evaluated in the Jung abscess on a nondependent region unless evidences of bronchial obstruction or bronchogenic carcinoma exist.
The pulmonary tuberculosis should be regarded as the underlying etiology of the nondependent lung abscess. |
| Key Words:
Lung Abscess, Cavity, Bronchoscopy |
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