Résumé
Empyema still remains one of the serious problems and challenge for a thoracic surgeon , despite the wide spread use of antibiotics and other surgical modalities its treatment is controversial with or without bornchpleural fistulae. Our experience in 200 patients of empyema with or without bronchopleural fistula was retrospectively reviewed. The causes of empyema were as follows. Parapneumonic (n=140), post tubercular empyema (n=20), following trauma (n=16), Post surgical (n=10), subdiaphragmatic pathology (n=2), oesophageal rupture (N=5) and underdetermined + 17. Broncho- pleural fisyula was found to be present in 20 % of these patients. Therapeutic thoracentesis was carried out successfully in 22 patients and closed tube thoracostomy in 178 patients and success was obtained in 89 patients (50 %) decortication alone in 60 patients (30 %). Thoracoplsty with muscle with muscle flap interposition in n=13, open drainage with rib resection (Eloesser flap) in ten patients , six patients refused any surgical intervention .