CT - After intercostal drainage tube insertion
Frontal SCOUT
Axial lung window
Axial non-contrast
What are the potential complications from a CT guided drain insertion for a lung abscess?
Complications from a drain insertion are similar to those from open surgery and include: pneumothorax, pleural or pulmonary haemorrhage, empyema and bronchopleural fistula.
What is the importance in distinguising between a primary and secondary lung abscess?
The importance is two-fold. Firstly, the aetiology is different. Primary abscess are de-novo, the consequence of a chronic or necrotising pneumonia or aspiration, as opposed to secondary that occur in patients with underlying conditions, typically an immunocompromised status. Secondly, the responsible organisms tend to be different. In secondary abscesses more opportunistic microorganisms are involved and hence require a different anti-microbial weaponry to treat.
Surgical emphysema, pneumothorax and pneumopericardium (probably due to pleuro-pericardial fistula which is a complication of infection) developed after ICD insertion.
Large right lung abscess (with ICD tube in-situ) and multiple cavities in both lungs.