PMC4458315_01
Old thoracostomy scars
PAMJ-20-115-g001.jpg
PMC4458315_01_PAMJ-20-115-g001.jpg
F0001
T = 38.5, O2 Saturation = 95% at room air, Weight = 78 Kg. There were obvious old thoracostomy scars (Figure 1) performed two years ago on the left chest wall.
Chest X ray on admission with left sided thick biconvex opacity
PAMJ-20-115-g002.jpg
PMC4458315_01_PAMJ-20-115-g002.jpg
F0002
His chest x-ray (Figure 2) showed left sided thick biconvex opacity occupying left lower and middle zone.
(a and b) CT scan chest showing left sided chronic empyema
PAMJ-20-115-g003.jpg
PMC4458315_01_PAMJ-20-115-g003.jpg
F0003
After having CT scan chest (Figure 3) an urgent external thoracic surgical consultation was requested as our hospital is a rehabilitation facility there is no thoracic surgical specialty.
Umblicated yellow red pre-rupture stage empyema thoracis necessitans
PAMJ-20-115-g004.jpg
PMC4458315_01_PAMJ-20-115-g004.jpg
F0004
The color of an old thoracostomy scar started changing dark brown to red color and in next 24-48 hours it became umblicated and yellow (Figure 4).
Post ICT Chest X ray showing non expanded left lung
PAMJ-20-115-g005.jpg
PMC4458315_01_PAMJ-20-115-g005.jpg
F0005
Patient was sent back to the unit where he felt better his temperature became less but his lung remained unexpanded with residual loculations and still residual pus on post intercostal tube (ICT) chest x-ray (Figure 5).
Post decortication chest X ray showing complete re expansion
PAMJ-20-115-g006.jpg
PMC4458315_01_PAMJ-20-115-g006.jpg
F0006
Patient remained stable made good uneventful recovery and was discharged home on 16-7-2013, his last chest x-ray shown (Figure 6).