TBC EMPYEMA
Internet connection has been down for almost two weeks, but otherwise we are doing fine with the infrastructures as a whole.
The x-ray equipment has been repaired by the German expert technician who was send and financed by our sister hospital in Rothenburg – Diakoniekrankenhaus Rothenburg in Wümme. The electric power from ELPA (Ethiopian Light and Power Association) has been very stable for an extended period. In Addis Abeba there has been stable electricity 24 hours around the clock for a very long time, just as in Europe. That is what we hope will happen to us here in the countryside as well. The telephone is working perfectly, and there is construction work going on to supply us with a mobile network! The road is becoming better and better – soon there will be asphalt almost all the way to Aira. Also the water supply has been very constant, due to repair and reconstruction by Mr Linz, a former missionary to Aira, who has been sent as a “senior expert” by the German Mission (ELM).
All in all we are doing fine.
It is a great relief that we have x-ray service again in the hospital. It is not easy to run a busy hospital without that service – certainly not when you are an orthopedic surgeon as I am. More than half year I have been doing orthopedic procedures as a blind person with a stick.
When this patient came with a left sited TBC pyo-pneumothorax (chronic TBC empyema) we had an x-ray taken…..
…..but we could have treated him on the clinical picture alone. The fresh burn marks from traditional treatment with hot iron on the left site of the thorax show us where the problem is. He has old marks as well on the epigastric area telling us that he has a history of previous abdominal disease.
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Fresh burn marks on the left thorax – red arrows. Old marks on the abdomen – white arrows |
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VIDEO ← click here for vatching video clip |
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Only right side of the chest is moving with respiration. |
Aspiration of puss with a puncture needle confirms that there is pus in the left thorax, and a chest tube can be inserted through a subcutaneous tunnel
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VIDEO ← click here for video clip
No air is escaping from the pleural cavity showing us that the lung will not expand. In this case with chronic TBC we will probably choose to leave the patient with a permanently collapsed lung draining only the pus with an open drainage system.
Tags: chest tube, chronic empyema, TBC, tuberculosis, tuberculous empyema