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THE PATHOGENESIS OF ASPIRATORY ABSCESS OF THE LUNG: ITS POSSIBLE RELATION TO ABSCESS OF THE LUNG FOLLOWING TONSILLECTOMY

THE PATHOGENESIS OF ASPIRATORY ABSCESS OF THE LUNG: ITS POSSIBLE RELATION TO ABSCESS OF THE LUNG... Abstract Pulmonary suppuration following tonsillectomy occurs with sufficient frequency to arrest the attention of both the surgeon and the internist, but the exact method of its development is still in dispute. Aschner,1 who studied the different types of pulmonary suppurative lesions encountered in the human being in the material obtained from resections of the lobe performed by Lilienthal, differentiated the following types: (1) bronchiectasis; (2) bronchiectatic abscess; (3) suppurative pneumonitis, and (4) extrabronchial abscess. Groups 3 and 4 frequently merge into each other, as areas of suppurative pneumonitis may break down and develop into a large extrabronchial abscess. It is the bronchiectatic abscess group which was of particular interest in the present investigation, as in each of the ten cases studied by Aschner this condition followed the operative removal of the tonsils and adenoids under general anesthesia. In one of the four cases of suppurative pneumonitis, the condition developed a few References 1. Aschner, P. W.: The Pathology of Lung Suppuration , Ann. Surg. 75:321 ( (March) ) 1922.Crossref 2. Cutler, E. C., and Hunt, A. M.: Post-Operative Pulmonary Complications , Arch. Surg. 1:114 ( (July) ) 1920Crossref 3. Post-Operative Pulmonary Complications , Arch. Int. Med. 29:449 ( (April) ) 1922.Crossref 4. Cutler, E. C.: The Etiology of Post-Operative Pulmonary Complications , S. Clin. N. Amer. 2:935 ( (Aug.) ) 1922. 5. Schlueter, S A., and Weidlein, I. F.: Post-Operative Lung Abscess , Arch. Surg. 14:457 ( (Feb.) ) 1927.Crossref 6. Lyman, H. W.: Relation of Nose and Throat Operations to Lung Abscess , J. Missouri M. A. 20:418 ( (Dec.) ) 1923. 7. Hedblom, C. A.: The Surgical Treatment of Acute Pulmonary Abscess , Illinois M. J. 47:267 ( (April) ) 1925. 8. Moore, W. F.: Pulmonary Abscess: An Analysis of Two Hundred and Two Cases Following Operative Work About the Upper Respiratory Passages , J. A. M. A. 78:1279 ( (April 29) ) 1922.Crossref 9. Herb, I. C.: Post-Operative Lung Complications , J. A. M. A. 79:339 ( (July 29) ) 1922.Crossref 10. Glowacki, B. F.: Pulmonary Abscess: A Study of Ninety Cases , Laryngoscope 33:153 ( (Feb.) ) 1923.Crossref 11. Keiper, G. F.: The Tonsil Question Up to Date , Laryngoscope 31:777 ( (Oct.) ) 1921.Crossref 12. Myerson, M. C.: Pulmonary Aspects of Tonsillectomy Under General Anesthesia , Laryngoscope 32:929 ( (Dec.) ) 1922Crossref 13. Lung Abscess Following Tonsillectomy: A Contribution to the Etiology , Arch. Otolaryng. 1:137 ( (Feb.) ) 1925.Crossref 14. Wessler, H.: Lung Abscess and Bronchiectasis: A Clinical and Roentgenological Study of 100 Cases , Am. J. Roentgenol. 6:161 ( (April) ) 1919 15. Suppuration and Gangrene of the Lung: A Study of 100 Cases , J. A. M. A. 73:1918 ( (Dec. 27) ) 1919.Crossref 16. Clendenning, L.: The Cause of Abscess of the Lung After Tonsillectomy , J. A. M. A. 74:941 ( (April 3) ) 1920Crossref 17. Abscess of Lung , Laryngoscope 32:128 ( (Feb.) ) 1922. 18. Grober: Ballenger Diseases of the Nose, Throat and Ear , Philadelphia, Lea & Febiger, 1914, p. 398. 19. Miller, W. S.: Some Essential Points in the Anatomy of the Lung , Am. J. Roentgenol. 4:269 ( (June) ) 1917 20. The Vascular Supply of the Pleura Pulmonalis , Am. J. Anat. 7:389, 1908. 21. Most, A.: Die Topographie des Lymphgefaessapparates des menschlichen Koerpers in ihren Beziehungen zur den Infectionswegen der Tuberkulose , Bibliotheca Medica , part C, no. 21, Stuttgart 22. Untersuchungen ueber die Lymphbahnen an der oberen Thoraxapertur und am Brustkorb , Arch. f. Anat. u. Entwcklngsgesch. 30:1, 1908. 23. Wessler stated that, on the contrary, involvement of the upper lobe is more frequent. 24. Holman, E.; Weidlein, I. F., and Schlueter, S. A.: A Method for the Experimental Production of Lung Abscess , Proc. Soc. Exper. Biol. & Med. 23:266, 1926. 25. Mason, E. C.: Blood Coagulation: The Production and Prevention of Experimental Thrombosis and Pulmonary Embolism , Surg. Gynec. Obst. 39:421 ( (Oct.) ) 1924. 26. Capelle, W.: Einiges zur Frage der postoperativen Thromboembolie , Beitr. z. klin. Chir. 199:485, 1920. 27. Porter, W. B.: Pulmonary Abscess Following Tonsillectomy Under Local Anaesthesia , Virginia M. Monthly 47:606 ( (March) ) 1921. 28. Simpson, J. R., and Noah, H. G.: Report of Two Cases of Lung Abscess Following Tonsillectomy Under Local Anaesthesia in Tubercular Subjects , Pennsylvania M. J. 23:332 ( (March) ) 1920. 29. Warthin, A. S., quoted by Frank, I.: On Lung Abscess as a Sequel to Tonsillectomy , Laryngoscope 27:474 ( (June) ) 1917. 30. Ochsner, A. J., and Nesbit, W.: Pulmonary Abscess , Arch. Otolaryng. 6:330 ( (Oct.) ) 1927. 31. Lemon, W. S.: Aspiration: Experimental Study , Arch. Surg. 12:187 ( (Jan.) ) 1926. 32. Hoelscher, R.: Experimentelle Untersuchungen ueber die Entstehung der Erkrankungen der Luftdege nach Aethernarkose , Arch. f. klin. Chir. 57:175, 1898. 33. Lambert, A. V. S., and Miller, J. A.: Abscess of the Lung , Arch. Surg. 8:446 ( (Jan.) ) 1924. 34. Scarff, J. E.: Pulmonary Blood Pressures: An Experimental Study , Arch. Surg. 12:591 ( (Feb.) ) 1926. 35. Kline, B. S.: Experimental Gangrene , J. Infect. Dis. 32:481 ( (June) ) 1923 36. Spirochaetal Pulmonary Gangrene , J. A. M. A. 77:1874 ( (Dec. 10) ) 1921. 37. Smith, D. T.: Experimental Aspiratory Abscess , Arch. Surg. 14:231 ( (Jan.) ) 1927. 38. Allen, D. S.: Etiology of Abscess of the Lung , Arch. Surg. 16:179 ( (Jan.) ) 1928. 39. No cultures were made in this case because the autopsy was not done under sterile conditions. 40. Many strains of streptococci cultivated on Noguchi mediums isolated from cases of abscess of the lung, which were employed in the experiments, showed definite proteolytic properties in vitro. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

THE PATHOGENESIS OF ASPIRATORY ABSCESS OF THE LUNG: ITS POSSIBLE RELATION TO ABSCESS OF THE LUNG FOLLOWING TONSILLECTOMY

HARKAVY, JOSEPH
Archives of Internal Medicine , Volume 43 (6) – Jun 1, 1929
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References (42)

Publisher
American Medical Association
Copyright
Copyright © 1929 American Medical Association. All Rights Reserved.
ISSN
0730-188X
DOI
10.1001/archinte.1929.00130290038002
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Abstract

Abstract Pulmonary suppuration following tonsillectomy occurs with sufficient frequency to arrest the attention of both the surgeon and the internist, but the exact method of its development is still in dispute. Aschner,1 who studied the different types of pulmonary suppurative lesions encountered in the human being in the material obtained from resections of the lobe performed by Lilienthal, differentiated the following types: (1) bronchiectasis; (2) bronchiectatic abscess; (3) suppurative pneumonitis, and (4) extrabronchial abscess. Groups 3 and 4 frequently merge into each other, as areas of suppurative pneumonitis may break down and develop into a large extrabronchial abscess. It is the bronchiectatic abscess group which was of particular interest in the present investigation, as in each of the ten cases studied by Aschner this condition followed the operative removal of the tonsils and adenoids under general anesthesia. In one of the four cases of suppurative pneumonitis, the condition developed a few References 1. Aschner, P. W.: The Pathology of Lung Suppuration , Ann. Surg. 75:321 ( (March) ) 1922.Crossref 2. Cutler, E. C., and Hunt, A. M.: Post-Operative Pulmonary Complications , Arch. Surg. 1:114 ( (July) ) 1920Crossref 3. Post-Operative Pulmonary Complications , Arch. Int. Med. 29:449 ( (April) ) 1922.Crossref 4. Cutler, E. C.: The Etiology of Post-Operative Pulmonary Complications , S. Clin. N. Amer. 2:935 ( (Aug.) ) 1922. 5. Schlueter, S A., and Weidlein, I. F.: Post-Operative Lung Abscess , Arch. Surg. 14:457 ( (Feb.) ) 1927.Crossref 6. Lyman, H. W.: Relation of Nose and Throat Operations to Lung Abscess , J. Missouri M. A. 20:418 ( (Dec.) ) 1923. 7. Hedblom, C. A.: The Surgical Treatment of Acute Pulmonary Abscess , Illinois M. J. 47:267 ( (April) ) 1925. 8. Moore, W. F.: Pulmonary Abscess: An Analysis of Two Hundred and Two Cases Following Operative Work About the Upper Respiratory Passages , J. A. M. A. 78:1279 ( (April 29) ) 1922.Crossref 9. Herb, I. C.: Post-Operative Lung Complications , J. A. M. A. 79:339 ( (July 29) ) 1922.Crossref 10. Glowacki, B. F.: Pulmonary Abscess: A Study of Ninety Cases , Laryngoscope 33:153 ( (Feb.) ) 1923.Crossref 11. Keiper, G. F.: The Tonsil Question Up to Date , Laryngoscope 31:777 ( (Oct.) ) 1921.Crossref 12. Myerson, M. C.: Pulmonary Aspects of Tonsillectomy Under General Anesthesia , Laryngoscope 32:929 ( (Dec.) ) 1922Crossref 13. Lung Abscess Following Tonsillectomy: A Contribution to the Etiology , Arch. Otolaryng. 1:137 ( (Feb.) ) 1925.Crossref 14. Wessler, H.: Lung Abscess and Bronchiectasis: A Clinical and Roentgenological Study of 100 Cases , Am. J. Roentgenol. 6:161 ( (April) ) 1919 15. Suppuration and Gangrene of the Lung: A Study of 100 Cases , J. A. M. A. 73:1918 ( (Dec. 27) ) 1919.Crossref 16. Clendenning, L.: The Cause of Abscess of the Lung After Tonsillectomy , J. A. M. A. 74:941 ( (April 3) ) 1920Crossref 17. Abscess of Lung , Laryngoscope 32:128 ( (Feb.) ) 1922. 18. Grober: Ballenger Diseases of the Nose, Throat and Ear , Philadelphia, Lea & Febiger, 1914, p. 398. 19. Miller, W. S.: Some Essential Points in the Anatomy of the Lung , Am. J. Roentgenol. 4:269 ( (June) ) 1917 20. The Vascular Supply of the Pleura Pulmonalis , Am. J. Anat. 7:389, 1908. 21. Most, A.: Die Topographie des Lymphgefaessapparates des menschlichen Koerpers in ihren Beziehungen zur den Infectionswegen der Tuberkulose , Bibliotheca Medica , part C, no. 21, Stuttgart 22. Untersuchungen ueber die Lymphbahnen an der oberen Thoraxapertur und am Brustkorb , Arch. f. Anat. u. Entwcklngsgesch. 30:1, 1908. 23. Wessler stated that, on the contrary, involvement of the upper lobe is more frequent. 24. Holman, E.; Weidlein, I. F., and Schlueter, S. A.: A Method for the Experimental Production of Lung Abscess , Proc. Soc. Exper. Biol. & Med. 23:266, 1926. 25. Mason, E. C.: Blood Coagulation: The Production and Prevention of Experimental Thrombosis and Pulmonary Embolism , Surg. Gynec. Obst. 39:421 ( (Oct.) ) 1924. 26. Capelle, W.: Einiges zur Frage der postoperativen Thromboembolie , Beitr. z. klin. Chir. 199:485, 1920. 27. Porter, W. B.: Pulmonary Abscess Following Tonsillectomy Under Local Anaesthesia , Virginia M. Monthly 47:606 ( (March) ) 1921. 28. Simpson, J. R., and Noah, H. G.: Report of Two Cases of Lung Abscess Following Tonsillectomy Under Local Anaesthesia in Tubercular Subjects , Pennsylvania M. J. 23:332 ( (March) ) 1920. 29. Warthin, A. S., quoted by Frank, I.: On Lung Abscess as a Sequel to Tonsillectomy , Laryngoscope 27:474 ( (June) ) 1917. 30. Ochsner, A. J., and Nesbit, W.: Pulmonary Abscess , Arch. Otolaryng. 6:330 ( (Oct.) ) 1927. 31. Lemon, W. S.: Aspiration: Experimental Study , Arch. Surg. 12:187 ( (Jan.) ) 1926. 32. Hoelscher, R.: Experimentelle Untersuchungen ueber die Entstehung der Erkrankungen der Luftdege nach Aethernarkose , Arch. f. klin. Chir. 57:175, 1898. 33. Lambert, A. V. S., and Miller, J. A.: Abscess of the Lung , Arch. Surg. 8:446 ( (Jan.) ) 1924. 34. Scarff, J. E.: Pulmonary Blood Pressures: An Experimental Study , Arch. Surg. 12:591 ( (Feb.) ) 1926. 35. Kline, B. S.: Experimental Gangrene , J. Infect. Dis. 32:481 ( (June) ) 1923 36. Spirochaetal Pulmonary Gangrene , J. A. M. A. 77:1874 ( (Dec. 10) ) 1921. 37. Smith, D. T.: Experimental Aspiratory Abscess , Arch. Surg. 14:231 ( (Jan.) ) 1927. 38. Allen, D. S.: Etiology of Abscess of the Lung , Arch. Surg. 16:179 ( (Jan.) ) 1928. 39. No cultures were made in this case because the autopsy was not done under sterile conditions. 40. Many strains of streptococci cultivated on Noguchi mediums isolated from cases of abscess of the lung, which were employed in the experiments, showed definite proteolytic properties in vitro.

Journal

Archives of Internal Medicine – American Medical Association

Published: Jun 1, 1929

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