Methods of Drainage

• Postural Drainage:
  Postural drainage should be instituted in all cases if possible to drain the abscess.This will facilitate drainage of pus. Patient should have empty stomach and prepared with bronchodilator and humidification prior to postural drainage.

  In most patients antibiotics and postural drainage is sufficient to cure lung abscess. However in some patients additional drainage options have to be entertained.

• Bronchoscopy:
  Fiberoptic bronchoscopy is very useful to drain the lung abscess, however cannot be used as a method of drainage daily. This method has to be reserved for situations when the postural drainage and antibiotics are failing to control infection and the cavity is enlarging.
• Percutaneous Chest Tube:
  1. CT Guided Percutaneous Drainage: One can select the site where the parietal and visceral pleura are adherent and the drain can be placed into the cavity.
  2. In past chest tube was placed into the cavity in two surgical steps. First pleural space was marsupialized by sutures between visceral and parietal pleura. Few days later chest tube was placed into the cavity through this site. This precaution was taken to avoid spilling of pus into pleural cavity .