Acta Chir Belg
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Bronchopleural fistula with empyema is an uncommon but tragic complication after pulmonary resection. The possible therapeutic procedures are discussed. The patient often requires multiple surgical interventions and prolonged hospitalisation. According to the literature, open window thoracostomy (OWT) and even mutilating interventions such as myoplasty or thoracoplasty have to be performed when simple chest-tube drainage and antibiotic therapy do not suffice as illustrated by the present case.
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The authors describe a patient who was admitted with total necrosis of the oesophageal and gastric mucosa after ingestion of concentrated sodium hydroxide solution. An emergency total gastrectomy and blunt, thoracic oesophageal stripping was performed. Three months later, the continuity of the digestive tract was restored by a retrosternal colon interposition. ⋯ I. tract is mandatory. If a third degree oesogastric mucosal burn is diagnosed urgent laparatomy should be performed to assess transmural wall necrosis. If present an oesophageal gastrectomy should be performed as a life saving intervention.