Niaz Hussain Soomro, Syed Waqar Ahmed, Aneeqa A Zafar, Khurram Rais, Anum Javed.
Tuberculous cold abscess of the chest wall; is surgery mandatory in all?.
Pak J Surg Jan ;31(1):45-8.

Objective:Th e aim of this study is to assess the success rate of aspiration and anti tuberculous therapy(ATT ) in cases of tuberculous cold abscess of chest wall. Study Design: Quasi Experimental study. Place of Study: Department of Th oracic Surgery Jinnah Post Graduate Medical Centre Karachi, Pakistan. Methodology: Aft er the approval of institutional review board, this study was conducted on 60 patients from December 2006 – April 2010. Aft er history, examination and informed consent, aspiration of cold abscess was done to confi rm the diagnosis. All patients were aspirated and started on ATT . Patients were followed for 6 weeks and treatment results observed by resolution of abscess. Th ose patients who responded well to aspiration and 6 weeks ATT were continued with the ATT for one year and others who failed to respond were proceeded for surgery and continued ATT post-operatively for one year. All patients were followed for one year. Results: Patients ages were between 15-45 years (mean 23). Out of sixty, 40 (67%) were males and 20 (33%) were females (M:F 2:1). Th e usual presentation was a solitary swelling in 58 (96.6%) patients. 28 (46.6%) patients responded well to aspiration and 6 weeks ATT with complete resolution of abscess with no recurrence during one-year follow up while other 32 (53.4%) patients who had a re-emergence of abscess, underwent surgery. Among these patients, an involved rib was also resected in 20 (33.3%) patients. No recurrence was seen aft er surgery. ATT was continued in both type of patients for a total period of one year. Conclusion: We recommend non dependent aspiration of cold abscess of chest wall with combination of ATT as the initial management. If however it fails, surgical intervention is mandatory for complete cure.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com