Intrathoracic Transposition of a Pedicled Latissimus Dorsi Muscle Flap for Complicated Chronic Empyema Thoracis: A Plea for its Popularity in our Subregion

I. I. Alioke, V. T. Ayongo

Abstract

INTRODUCTION: Empyema thoracis is a debilitating disease that
still constitutes a significant burden among thoracic surgical diseases
in our environment. It sometimes occurs secondary to ruptured lung
abscess with varying degrees of lung destruction and bronchopleural
fistula.

CASE REPORT: A 65-year-old woman presented to our unit with a
two-month history of cough which subsequently became productive
of purulent sputum and posture-dependent, and fever, with
progressive dyspnea on exertion. She was subsequently managed for
chronic right empyema thoracis secondary to a ruptured lung
abscess. We briefly describe the evaluation, indication and technique
for intrathoracic transposition of a pedicled latissimus dorsi muscle
flap for operative management of this index disease, and the very
good medium and long-term outcomes observed for this patient.

CONCLUSION: Where indicated and with meticulous preoperative
planning, transposition of a pedicled latissimus dorsi
muscle flap for complicated chronic empyema thoracis can prevent a
surgical albatross with a reduced hospital stay, cost of treatment and
excellent patient satisfaction at the meagre expense of about 30
minutes or less extra intra-operative time.
WAJM 2024; 41 (1): 82 - 86.

KEYWORDS: Lung abscess, pedicled latissimus dorsi, empyema
thoracis, outcomes.