ABSTRACT

Empyema can occur after any surgery that involves exposure of the pleural space; however, it occurs relatively uncommonly in cases of lung or chest wall resection where the lung is fully expanded within the thorax because the rich blood supply of the lung provides a robust immune presence within the pleura. Coughing after lung or chest wall surgery is important in terms of clearing the airways of secretions that result from intubation with airway trauma or secretions from regions of lung that have undergone resection. Any excessive bleeding from the chest tubes placed during surgery for lung or chest wall resection should be followed by plain films of the chest to rule out hemothorax, the presence of which mandates a return to the operating room for hemothorax evacuation and control of bleeding sources. Bleeding that originates from the pulmonary artery or vein can be massive and immediately life threatening.