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Spontaneous pneumothorax in children--a review of 95 cases
M H Beg1, Reyazuddin, M M Faridi
1Department of General Surgery, J. N. Medical College, A. M. U., Aligarh, India.
Insights
Spontaneous pneumothorax in children is often caused by lung infections or tuberculosis. Tube thoracostomy drainage is a successful treatment, with most children experiencing full relief.
Area of Science:
- Pediatrics
- Pulmonology
- Infectious Diseases
Background:
- Spontaneous pneumothorax (SP) in children is a rare but serious condition.
- Identifying underlying causes is crucial for effective management.
- Tropical regions present unique etiological patterns for pediatric SP.
Purpose of the Study:
- To investigate the causes and outcomes of spontaneous pneumothorax in pediatric patients in a tropical setting.
- To evaluate the efficacy of tube thoracostomy drainage for pediatric SP.
Main Methods:
- Retrospective review of 95 pediatric patients (newborn to 12 years) with spontaneous pneumothorax.
- Analysis of patient demographics, clinical presentation, underlying causes, treatment, and outcomes.
- Data collection on symptom duration, mortality, and treatment success rates.
Main Results:
- Pyogenic lung infection (74.8%) and pulmonary tuberculosis (21%) were the predominant causes of SP.
- The average symptom duration was 5 days, including cough, chest pain, and breathlessness.
- Tube thoracostomy drainage resulted in full relief for 94.79% of patients; 5.21% mortality was associated with severe pre-existing infections.
Conclusions:
- Pyogenic pulmonary infections and tuberculosis remain the leading causes of pediatric spontaneous pneumothorax in tropical areas.
- Tube thoracostomy drainage is a highly successful and safe intervention for pediatric SP.
- Thoracotomy is a viable option for selected pediatric cases requiring surgical intervention.
Abstract:
We reviewed the records of 95 consecutive patients with spontaneous pneumothorax. The children, 75 boys and 20 girls, ranged in age from newborn to 12 years. The average duration of symptoms, cough, chest pain and breathlessness, was 5 days. Pyogenic lung infection (74.8%) and pulmonary tuberculosis (21%) were the commonest underlying causes of pneumothorax. All children underwent tube thoracostomy drainage along with supportive treatment. Five died owing to sever infection present at the time of admission. Except for the five (5.21%) who died, all children (94.79%) had full relief of pneumothorax. We conclude that pyogenic pulmonary infection and pulmonary tuberculosis are still the commonest causes of pneumothorax in the tropics. Tube thoracostomy drainage is very successful and thoracotomy in selected patients is safe.