Management of Post-Pneumonectomy Empyema and Bronchopleural Fistula in Nigeria

This report reviews our experience with six patients with post-pneumonectomy empyema and bronchopleural fistula over a ten-year period (1969-1978) at the University College Hospital, Ibadan. The most common indications for pneumonectomy in this environment are TB-destroyed lung and suppurative diseases of the lung complicated by massive hemoptysis. Five of the six patients who developed these complications presented with life threatening hemoptysis due to lung abscess and pulmonary aspergillosis. The sixth patient presented with TB destroyed lung. This study shows that these complications are more common following emergency pulmonary resection for suppurative lung diseases and following the removal of the right lung. We have achieved the best results with initial closed chest tube drainage followed by continuous pleural irrigation and later by Clagett procedure or open tube drainage.