Surgical Treatment of Chest Wall Tuberculosis

Authors

Department of Thoracic Surgery, Guilan University of Medical Sciences (GUMS), Razi Hospital, RASHT- IRAN.

Abstract

Background: Tuberculosis remains a formidable challenge to health care providers in developing countries and chest wall
tuberculosis is a rare entity .Its clinical presentation may resemble a pyogenic abscess or chest wall tumor. There is still
controversy regarding the diagnosis and treatment of chest wall tuberculosis.
Materials and Methods: During a 10-year period (1998–2009), 12 cases with chest wall tuberculosis were managed by our
team. Patients’ medical records were retrospectively reviewed. After confirming the diagnosis by histopathological
examination, patients underwent surgical management.
Results: There were 8 male and 4 female patients. Patients’ age ranged from 4 to 60 years. Eight patients had a fluctuating
abscess and 4 had a chest wall mass. Surgical procedure was drainage along with debridement in 6 patients, wide
debridement along with rib resection in 2 patients and wide debridement along with chest wall resection and reconstruction in
4 patients. Recurrence of cold abscess and fistula formation were detected in 2 patients after a follow-up of 1 to 5 years.
Outcome of patients with chest wall tuberculosis was good.
Conclusion: chest wall tuberculosis mimics symptoms and signs of chest wall tumors or abscesses. The combination of
symptoms and radiographic findings suggests the diagnosis of tuberculosis. Wide debridement and resection are shown to
have lower rates of fistula formation, sinus formation and recurrence. Medical treatment must be started immediately after
surgery. (Tanaffos2010; 9(3): 28-32)

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