The management of
lung abscess is usually conservative. However, in some cases drainage is necessary, commonly performed transcutaneously. Endobronchial
catheter drainage is a potential alternative, though reported only sporadically. Transbronchial pigtail
catheter drainage was used in 3 patients with refractory
lung abscesses at our centre. The
catheter was introduced endobronchially under bronchoscopic procedure.
Laser was used to perforate the
abscess wall through the airway into the
abscess in order to provide a pathway for
catheter insertion. An improvement in clinical and radiological parameters was noted immediately after
catheter placement. The
catheters were extracted after 4-6 days. All patients had a complete clinical recovery. Endobronchial
catheters with the use of
laser appear to be relatively safe and effective for the treatment of
pulmonary abscess in selected patients in whom the
abscess is adjacent to the central airway. When necessary, a bulge in an adjacent airway can be perforated with
laser. To the best of our knowledge, there have been no previous reports of endobronchial drainage with the use of
laser.