Plombage

Changed by Yuranga Weerakkody, 20 Mar 2015

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Plombage, also known as extraperiosteal or extrapleural pneumonolysis,  is a historical treatment method for cavitary tuberculosis of the upper lobes of the lungs. It was used in the 1930s, 1940s, and 1950s prior to the introduction of effective antituberculous drugs, when treatment of tuberculosis consisted of rest, isolation and proper nutrition.

Etymology

The term derives from the latin word for lead: plumbum

Technique

A cavity was created surgically underneath the upper ribs, and the space was filled with inert material. Candidate substances included lucite (acrylic) balls1, pingpong balls, oils, rubber sheets, paraffin wax, gauze. As a result, the upper lobe of the lung would collapse. The theory was that a collapsed lung would heal quicker.

Complications

Possible complications included haemorrhage and fistulisation to pleura, airways, oesophagus, skin and major thoracic vessels2, as well as infection which has been reported to occur as late as 57 years after plombage.3

ImagingRadiographic features

Features at imaging depend on the material used. In case of lucite balls, multiple rounded ring shadows are seen in the upper zone (usually unilateral), with associated chest wall deformity and resected ribs. Often, other signs of tuberculosis such as calcified granulomas or lymph nodes are seen.

History and etymology

The term "plombage" derives from the latin word for lead: plumbum

See also

  • -<p><strong>Plombage</strong>, also known as <strong>extraperiosteal</strong> or <strong>extrapleural pneumonolysis</strong>,  is a historical treatment method for cavitary <a href="/articles/tuberculosis">tuberculosis</a> of the upper lobes of the lungs. It was used in the 1930s, 1940s, and 1950s prior to the introduction of effective antituberculous drugs, when treatment of tuberculosis consisted of rest, isolation and proper nutrition.</p><h4>Etymology</h4><p>The term derives from the latin word for lead: <em>plumbum</em></p><h4>Technique</h4><p>A cavity was created surgically underneath the upper ribs, and the space was filled with inert material. Candidate substances included lucite (acrylic) balls<sup>1</sup>, pingpong balls, oils, rubber sheets, paraffin wax, gauze. As a result, the upper lobe of the lung would collapse. The theory was that a collapsed lung would heal quicker.</p><h4>Complications</h4><p>Possible complications included haemorrhage and fistulisation to pleura, airways, oesophagus, skin and major thoracic vessels<sup>2</sup>, as well as infection which has been reported to occur as late as 57 years after plombage.<sup>3</sup></p><h4>Imaging features</h4><p>Features at imaging depend on the material used. In case of lucite balls, multiple rounded ring shadows are seen in the upper zone (usually unilateral), with associated chest wall deformity and resected ribs. Often, other signs of <a href="/articles/tuberculosis">tuberculosis</a> such as calcified granulomas or lymph nodes are seen.</p><h4>See also</h4><ul><li>article on <a href="/articles/medical-devices-in-the-thorax">medical devices in the thorax </a>
  • +<p><strong>Plombage</strong>, also known as <strong>extraperiosteal</strong> or <strong>extrapleural pneumonolysis</strong>,  is a historical treatment method for cavitary <a href="/articles/tuberculosis">tuberculosis</a> of the upper lobes of the lungs. It was used in the 1930s, 1940s, and 1950s prior to the introduction of effective antituberculous drugs, when treatment of tuberculosis consisted of rest, isolation and proper nutrition.</p><h4>Technique</h4><p>A cavity was created surgically underneath the upper ribs, and the space was filled with inert material. Candidate substances included lucite (acrylic) balls<sup>1</sup>, pingpong balls, oils, rubber sheets, paraffin wax, gauze. As a result, the upper lobe of the lung would collapse. The theory was that a collapsed lung would heal quicker.</p><h4>Complications</h4><p>Possible complications included haemorrhage and fistulisation to pleura, airways, oesophagus, skin and major thoracic vessels<sup>2</sup>, as well as infection which has been reported to occur as late as 57 years after plombage.<sup>3</sup></p><h4>Radiographic features</h4><p>Features at imaging depend on the material used. In case of lucite balls, multiple rounded ring shadows are seen in the upper zone (usually unilateral), with associated chest wall deformity and resected ribs. Often, other signs of <a href="/articles/tuberculosis">tuberculosis</a> such as calcified granulomas or lymph nodes are seen.</p><h4>History and etymology</h4><p>The term "plombage" derives from the latin word for lead: <em>plumbum</em></p><h4>See also</h4><ul><li>article on <a href="/articles/medical-devices-in-the-thorax">medical devices in the thorax </a>

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