• Journal of Chest Surgery
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• v.8 no.2
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• pp.159-168
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• 1975

We have experienced 61 cases of Clinically diagnosed tuberculous peripleural abscess which was surgically treated at St. Mary's Hospital of Catholic Medical College from Mar. 1963 to Feb. 1974. Out of them, 52 cases of pathologically confirmed tuberculous peripleural abscess were reviewed and its pathogenesis, treatment and so called "rib caries" were discussed. In the past, they have been described as a variety of the names, such as rib caries, cold abscess of the chest wall, pericostal abscess, lymphadenitis tuberculosa of the chest wall, chronic draining sinuses of the chest wall and other descriptive terms. Although it has been said that the tuberculous abscess on the chest wall developed as a secondary disease from so called "rib caries" but now it has been clear that this abscess occurred not from tuberculosis of the rib but from tuberculous lesion developed between end-othoracic fascia and parietal pleura usually following pulmonary tuberculosis and/or tuberculous pleurisy and the involvement of rib or ribs are secondary one from peripleural abscess, as we confirmed. Therefore we advocate that the nomination, rib caries, should not be used unless there is a primary tuberculous lesion on ribs. The results were as follows: 1. The highest age group of tuberculous peripleural abscess was ranged from the first to third decade (78%) 2. The location of tuberculous peripleural abscess on the chest wall were as follows, 31 cases on the anterior, 19 cases on lateral and 2 cases on the posterior. 3. On x-ray examination, abnormal findings including parenchymal tuberculous lesion and pleural changes were seen is 38 cases. 4. There was no destructive change of periosteum and rib in 23 cases of tuberculous peripleural abseess during operation. However the periosteal denudation and/or rib destruction were found in 29 cases. 5. The all cases of tuberculous peri pleural abscess developed from between endothoraclc fascia and parietal pleura, as we confirmed. With antituberculous therapy, operation should be radical by wide incision on the lesion including thorough curettage with proper drainage of Iiquified caseating materials and appropriate rib resection, if necessary.tion, if necessary.

• Annals of Clinical Neurophysiology
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• v.4 no.2
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• pp.140-145
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• 2002

Neurologic sequelae of tuberculous meningitis include hemiparesis, paraparesis, quadriparesis, aphasia, developmental delay, dementia, blindness, visual field defect, deafness, cranial nerve palsies, epilepsy, and hypothalamic and pituitary dysfunction. But cervical epidural abscess and cervical spondylitis are rare. A 64-year-old woman who was diagnosed as tuberculous meningitis presented a severe neck pain and stiffness after 3 weeks of anti-tuberculous medication. Electromyography and cervical X-ray showed a cervical spondylosis with polyradiculopathy. But cervical MRI showed an acute cervical epidural abscess and mild cervical spondylitis. After continuous anti-tuberculous medication with supportive care, she showed a slow clinical improvement. But about 1 month of anti-tuberculous therapy, she presented a more aggravation of neck pain, neck stiffness, radicular pain, and neck motion limitation. Follow-up cervical MRI showed an more advanced cervical spondylitis. Afterthen she has recovered slowly by cervical laminectomy with posterior stabilization and continuous anti-tuberculous medication.

• Advances in pediatric surgery
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• v.19 no.2
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• pp.150-155
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• 2013

Tuberculous Iliopsoas muscle abscess is a rare manifestation in patient with extrapulmonary tuberculosis and hardly observed in developed country. Paradoxical response to anti-tuberculous medication could make difficult therapeutic decision to clinicians. The authors report a case of tuberculous iliopsoas muscle abscess with multiple intraabdominal and thoracic abscesses in 9 year-old-boy who presented paradoxical response to anti-tuberculous treatment.

• Tuberculosis and Respiratory Diseases
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• v.65 no.6
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• pp.517-521
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• 2008

A tuberculous psoas abscess is a frequently described complication of tuberculous spondylitis. Although rare, a tuberculous psoas abscess can develop without any demonstrable spinal involvement. In patients with no evidence of sponylitis, the abscess may result from direct spread from the involved lymph node or via a hematogeous route. The treatment of a psoas abscess is either drug therapy or surgical intervention in conjunction with drug therapy. Image-guided percutaneous drainage in conjunction with drug therapy is also a safe and effective treatment for a tuberculous psoas abscess. We report an unusual case of bilateral tuberculous psoas abscesses without any concomitant spinal involvement. The tuberculous psoas abscess may have formed by fistulization between the necrotic lymph node and psoas sheath. The diagnosis was confirmed by computed tomography and a histology examination of the biopsy sample. The patient improved after administering anti-tuberculous agents for 2 years along with surgical and percutaneous drainage of the abscess.

• Journal of Chest Surgery
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• v.17 no.1
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• pp.140-143
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• 1984

We have experienced 30 patients of tuberculous chest wall abscess which was surgically treated at Kyung Hee University hospital during 6 years from Jan, 1978 to Dec, 1983. We analyze 30 cases of clinical findings and surgically treated, and 20 cases of chest X-rays are available. The results of this sturdy are as follows: 1.Sex ratio ; Male: Female = 1:1.72. 2.Chief complaints are fluctuated mass with or without tenderness or pain and pus from wound. 3.Out of 20 cases of chest x-rays revealed 8 cases of osteolytic lesion, 11 cases of soft tissue swelling, 5 cases of pleural changes and 4 cases of negative findings. 4.We resected partially 43 ribs of 30 patients [average: 1.43 resected] in tuberculous chest wall abscess. 5.Operative methods of tuberculous chest wall abscess were partial resection of destructed or denuded periosteum of ribs and curettage of its surrounding tissues in operative field.

• Journal of Chest Surgery
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• v.45 no.3
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• pp.177-182
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• 2012

Background: Tuberculous abscess of the chest wall is a very rare disease. Few articles have reported on it and those that have enrolled few patients. To determine the characteristics of this disease and to suggest an optimal treatment strategy, we reviewed patients treated by surgical management. Materials and Methods: Between October 1981 and December 2009, 68 patients treated by surgical management for a tuberculous abscess of the chest wall were reviewed retrospectively. Results: Of 33 men and 35 women, 31 patients had a current or previous history of tuberculosis. The main complaints were chest pain, a palpable mass, pus discharge, and coughing. A preoperative bacteriologic diagnosis was performed in 12 patients. Abscess excision was performed in 54 cases, abscess cavity excision and partial rib resection in 13, and abscess excision and partial sternum and clavicle excision in 1 case. Postoperative wound infection was noted in 16 patients and a secondary operation was performed in 1 patient. Recurrence occurred in 5 patients (7.35%). Reoperation with abscess excision and partial rib resection was performed in all of the 5 cases. Conclusion: Complete excision of the abscess and primary closure of the wound with obliteration of space would decrease postoperative complications. Anti-tuberculosis medication may reduce the chance of recurrence.

• Journal of Chest Surgery
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• v.12 no.1
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• pp.61-66
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• 1979

This is a report of a case of tuberculous esophageal perforation, which was surgically treated.. The patient was 32-year-old Korean female patient, who complained swallowing difficulty for` 4 weeks duration. Esophagogram was shown irregular filling defects in the upper one third of esophagus, about 4 cm in length. It was noticed that a small amount of contrast media was leaked out from the involved area of esophagus into the right mediastinum. It was highly suggested that abscess formation was due to perforation of esophageal cancer. Esophagoscopy revealed no definitive evidence of perforation of esophagus, but punch biopsy specimen of esophageal mucosa was shown acute and chronic inflammatory changes. Operation was performed under impression of esophageal cancer. In the right-sided upper mediastinum, a walnut-sized abscess cavity which was connected with esophagus through a fistulous tract was noted. A portion of cavity submitted for frozen section was shown tuberculous inflammation. The abscess cavity, fistula tract, and involved esophageal wall were removed. The perforated esophagus was closed layer by layer. The tuberculous changes were confirmed by histopathologic examination postoperatively. The postoperative course was uneventful.

• Journal of Chest Surgery
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• v.24 no.8
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• pp.830-835
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• 1991

Tuberculosis is a chronic disease caused by Mycobacterium tuberculosis, which usually affects the lung but may cause lesions in any organ or tissue of the human body. Mediastinal lymph node involvement is common feature of intrathoracic tuberculosis in children. Sometimes the lymph node may be enlarged and it causes compressive symptoms. Recently we experienced two cases of tuberculous abscess at middle mediastinum. The abscess seemed to be originated from the mediastinal lymphadenitis, and caused the symptoms. Operation was performed by median sternotomy and by posterolateral thoracotomy incision respectively for the purpose of relieving symptoms and diagnosing the mediastinal mass. The symptoms were relieved completely and postoperative course was uneventful.

• Journal of Chest Surgery
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• v.24 no.6
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• pp.585-589
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• 1991

We experienced a rare hepatic tuberculous granuloma with subphrenic abscess. The patient was 45-years old female. She complained the right flank pain and tenderness on the protruding mass for 2 weeks. It was fixed, erythematous and 5x5cm sized mass, which was thought as cold abscess. She has done the hysterectomy as endometriosis at November 1990. Under general endotracheal anesthesia, the mass was incised, but the pus was not found. The needle aspiration was done through the 8th ICS, then the yellowish non-foul odor pus was rushed out. The 7th and 8th ribs were resected segmentally about 5cm. The abscess cavity was placed in the subphrenic area, therefore the operative fields extended along the 8th ICS. After the evacuation of subphrenic abscess, the granulomatous tissues from the superior aspect of liver was seen. The granuloma was resected and the penrose drainage was inserted. The tuberculosis was resulted from the 8th ICS muscles. subphrenic abscess and granuloma on the pathology report.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1221-1224
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• 1990

Fifty -six cases of tuberculous peripleural abscess were experienced in the department of thoracic and cardiovascular surgery, college of medicine, Hallym university from January 1980 to June 1990. Tuberculous peripleural abscess seems to originate from the space between the parietal pleura and endothoracic fascia. But rib caries, originated by hematogenous spread of mycobacteria to the rib, shows the rib destruction first, thereafter periosteal erosion and regional tissue involvement follows. In our 56 cases, results were as follows: 1. Their age ranged from 6 to 82 years, and female dominant [M: F=21: 35]. 2. The locations of abscess were 31 right, 23 left, and 2 sternal portions. 3. On X \ulcornerray findings, 37 cases showed active or old lesion of the tuberculosis in the lung field, 7 cases periosteal destruction of the ribs, and 29 cases pleural thickening. 4. Operative findings showed cold abscess with multiple fistulous tracts leading to intercostal space in most of the cases, and their origin were presumed to be from the space between the endothoracic fascia and parietal pleura. 5. The pus showed negative AFB stain in most of the cases except 3 cases. 6. Partial costectomy and radical curettage with drainage were performed in all cases. 7. 7 cases recurred after the first operations, but no recurrence after second operations.