Dec 10, 2024 · Pleural empyema refers to a collection of pus in the pleural cavity which may contain gas locules. Empyema is usually unilateral and most often occurs as a complication of pneumonia or perforated esophagus.

Sep 20, 2024 · An empyema is a purulent exudative collection within a body cavity. They occupy a pre-existing anatomical space. This is in contrast to an abscess, which arises within the parenchymal tissue itself.

May 9, 2024 · Features suggestive of an empyema include: enhancing thickened pleura (see split pleura sign) whereas pleural effusion has thin imperceptible pleural surfaces; locules of gas absent unless recent thoracocentesis; obvious septations; associated consolidation; associated adjacent infection (e.g. subdiaphragmatic abscess) Biochemistry/Microbiology ...

Zoomed chest X-ray PA view shows radio-opacity in the left middle and upper zones. The opacity has its broadest base peripherally in keeping with a chest wall based abnormality, in this case the pleural space.

Dec 9, 2022 · Distinguishing between an empyema and a peripherally located pulmonary abscess is essential. A pulmonary abscess is usually managed with prolonged antibiotics and physiotherapy with postural drainage, whereas an empyema usually requires percutaneous or surgical drainage.

Chest x-ray demonstrates multiple air fluid levels in the lower part of the right hemithorax. This is associated with patchy areas of consolidation, possibly with areas of cavitation. The left side is unremarkable.

Oct 30, 2024 · Chest radiographs are the most commonly used examination to assess for the presence of pleural effusion; however, it should be noted that on a routine erect chest x-ray as much as 250-600 mL of fluid is required before it becomes evident 6. A lateral decubitus projection is most sensitive, able to identify even a small amount of fluid.

Sep 22, 2024 · The split pleura sign is seen with pleural empyemas and is considered the most reliable CT sign helping to distinguish an empyema from a peripheral pulmonary abscess (see empyema vs pulmonary abscess) 1,2.

Findings are typical for an empyema, especially the "split pleura" sign. In the absence of instrumentation, gas in the collection indicates the development of a bronchopleural fistula, which is often seen in cases of empyema.

This case is a nice example of emphysema on chest x-ray without overtly flattened hemidiaphragms but quite increased retrosternal airspace that contributes to lung hyperexpansion.