tubercular empyema on ATT 6 weeks tube position done multiple times not resolved what next ?

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repositioning of tube

Position of tube is not correct.

vats...ll b more helpful rather than streptokinase for fibrinolysis

as per clinical histry it's suggestive of bpf...methylene blue dye test can be done..via icd or through bronchoscopically to confirm bpf... Cect thorax to asses the pleural rind..MIP images on ct r helpful to find out d fistula site.. vats decortication is gud option if available..

it is not BPF , It's thickened pleura with empyema
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agree about intra pleural STK then negative pressure drainage

Video Assisted Thoracoscopy with decortication if necessary

tube position seems incorrect. repositioning of tube needed.intrapleural streptokinse may be added.if patient is not in sepsis then steroid may be added

Trapped Lung. BPF

Kindly do usg guided tube placement.. keep continuos milking of the tube.. maintain patency of the tube.. After all this precautionary measures if fluid doesnt come out go for HRCT thorax n see for loculations You might need to drain each loculations seperately

Decortication can be done after thoracotomy.any bpf is there?

no bpf
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