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EXPERIMENTAL PLEURAL ADHESIONS

SAMUEL HIRSHFELD, M.D.; JOHN COHEN, M.D.; ARTHUR PURDY STOUT, M.D.
Arch Surg. 1933;26(5):892-900. doi:10.1001/archsurg.1933.01170050162009.
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A variety of surgical procedures for abscess of the lung is in practice at the present time, ranging from simple drainage, unroofing and ventilation to pneumonectomy. The most dangerous complication of these operative procedures is entry of the free pleura with resultant fatal putrid empyema. A lung with a putrid focus and a nonadherent, or inadequately adherent, pleura at the site of the focus, therefore, contraindicates operation until adequate adhesions have been formed to prevent pleural invasion. We accept the idea that the pleura partakes in the process of infections of the lung, such as abscess and, sometimes, bronchiectasis. In abscess of the lung the infection is lodged in the smaller bronchi in the early stage of the disease. The lung then undergoes a process of putrid liquefaction, and a more or less extensive surrounding pneumonitis ensues. The adjacent pleura is involved with a. resulting pleuritis. As the process extends,

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