Difficulties in the diagnosis and treatment of tuberculosis pleural empyema complicated with chest wandering abscess, diaphragm destruction and penetration into the liver.

Difficulties in the diagnosis and treatment of tuberculosis pleural empyema complicated with chest wandering abscess, diaphragm destruction and penetration into the liver.

Giller D.B., Martel I.I., Enilenis I.I., Koroev V.V., Kesaev O.SH., Giller B.D., Bizhanov A.B., Grigo-ryev Yu.G., Lavrov V.N.

Purpose. To show the difficulty of diagnosis and treatment of atypical course of tuberculous empyema, when the process was complicated by tuberculosis of the chest, destruction of the diaphragm and penetration into the liver. Results. After chest MSCT scan, tuberculosis was suspected. The patient successfully underwent surgery: Pleurectomy with chest wandering abscess excision, resection of the VII rib and abdominal wandering abscess excision combined with the diaphragm and liver resec-tion. The postoperative period was uncomplicated. During examination 4 years after surgery the patient was in a satisfactory condition, has ability to work, was transferred to group III dispensary tuberculosis registration. Discussion. Diagnosis and treatment of pleural empyema in some cases is difficult and, sometimes, requires differentiation from the oncological process. We have not found cases of tuberculous empyema spread of in the abdominal cavity with penetration into the liver in the literature. Conclusion. MSCT scan allowed to timely diagnose the atypical course of tuberculous empyema.

1-M.I. Perelman Department of Phthisiopulmonology and Thoracic Surgery, I.M. Sechenov First Moscow State Medical University (Sechenov University).

2- Department of Phthisi-ology and Pulmonology, A.I. Evdokimov Moscow State University of Medicine and Dentistry.

3- «CSRIT» Ministry of Education and Science of the Russian Federation. Moscow, Russia.

Keywords: tuberculosis, empyema, liver penetration, pleurectomy, diaphragm destruction.

Corresponding author: Giller D.B., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

For citation: Giller D.B., Martel I.I., Enilenis I.I., Koroev V.V., Kesaev O.SH., Giller B.D., Bizhanov A.B., Grigoryev Yu.G., Lavrov V.N. Difficulties in the diagnosis and treatment of tuberculosis pleural empyema complicated with chest wandering abscess, diaphragm destruction and penetration into the liver. REJR 2018; 8(4):262-268. DOI:10.21569/2222-7415-2018-8-4-262-268.

Received: 20.10.18 Accepted: 11.11.18