case_images: PMC4458315_01
case_images: Old thoracostomy scars
case_images: PAMJ-20-115-g001.jpg
case_images: PMC4458315_01_PAMJ-20-115-g001.jpg
case_images: F0001
case_images: T = 38.5, O2 Saturation = 95% at room air, Weight = 78 Kg. There were obvious old thoracostomy scars (Figure 1) performed two years ago on the left chest wall.
case_images: Chest X ray on admission with left sided thick biconvex opacity
case_images: PAMJ-20-115-g002.jpg
case_images: PMC4458315_01_PAMJ-20-115-g002.jpg
case_images: F0002
case_images: His chest x-ray (Figure 2) showed left sided thick biconvex opacity occupying left lower and middle zone.
case_images: (a and b) CT scan chest showing left sided chronic empyema
case_images: PAMJ-20-115-g003.jpg
case_images: PMC4458315_01_PAMJ-20-115-g003.jpg
case_images: F0003
case_images: After having CT scan chest (Figure 3) an urgent external thoracic surgical consultation was requested as our hospital is a rehabilitation facility there is no thoracic surgical specialty.
case_images: Umblicated yellow red pre-rupture stage empyema thoracis necessitans
case_images: PAMJ-20-115-g004.jpg
case_images: PMC4458315_01_PAMJ-20-115-g004.jpg
case_images: F0004
case_images: The color of an old thoracostomy scar started changing dark brown to red color and in next 24-48 hours it became umblicated and yellow (Figure 4).
case_images: Post ICT Chest X ray showing non expanded left lung
case_images: PAMJ-20-115-g005.jpg
case_images: PMC4458315_01_PAMJ-20-115-g005.jpg
case_images: F0005
case_images: Patient was sent back to the unit where he felt better his temperature became less but his lung remained unexpanded with residual loculations and still residual pus on post intercostal tube (ICT) chest x-ray (Figure 5).
case_images: Post decortication chest X ray showing complete re expansion
case_images: PAMJ-20-115-g006.jpg
case_images: PMC4458315_01_PAMJ-20-115-g006.jpg
case_images: F0006
case_images: Patient remained stable made good uneventful recovery and was discharged home on 16-7-2013, his last chest x-ray shown (Figure 6).