Complications of Enzymatic Debridement in Pulmonary Tuberculosis with Bronchopleural Fistula

¹ The Departments of Surgery and Pathology of the National Jewish Hospital and the Department of Pathology of the University of Colorado, School of Medicine, Denver, Colorado.

The results of the treatment of eight cases of tuberculous empyema with bronchopleural fistula and of one case of open cavernostomy by enzymatic debridement are reported. Trypsin was used almost exclusively. In eight cases the tuberculous exudate diminished and was converted to a thin fluid. Disseminated acute pulmonary tuberculosis developed in three patients as the result of aspiration of infected fluid through bronchial fistulae. One of these cases, which terminated fatally, also exhibited tuberculous pericarditis as a complication. The presence of a bronchial fistula' is a hazard in the enzymatic treatment of tuberculous empyema.