Empyema thoracis in children: Still a challenge in developing countries
Vikas Goyal1, Ajay Kumar, Monica Gupta
1Department of Surgery, G.G.G.S. Medical College, Faridkot, Punjab, India.
Insights
Tube thoracostomy is effective for pediatric empyema thoracis, with decortication showing success when needed. Early intervention reduces septic load and improves outcomes in children with this condition.
Area of Science:
- Pediatric Surgery
- Thoracic Medicine
- Infectious Diseases
Background:
- Empyema thoracis is a significant pediatric thoracic infection.
- Effective surgical management strategies are crucial for pediatric patients.
Purpose of the Study:
- To evaluate the effectiveness of surgical interventions for pediatric empyema thoracis.
- To assess outcomes of tube thoracostomy and decortication in children.
Main Methods:
- Retrospective study of 70 pediatric patients (1-14 years) with empyema thoracis.
- Analysis of tube thoracostomy success rates and outcomes of decortication.
Main Results:
- Tube thoracostomy was successful in 78.6% of cases.
- Decortication was required in 12 patients and was successful in all.
- Staphylococcus aureus was the most common pathogen identified.
Conclusions:
- Tube thoracostomy is recommended for all stages of pediatric empyema thoracis to reduce septic load.
- Prompt decision-making for decortication is advised for optimal patient recovery.
Background:
To evaluate the effectiveness of surgical intervention in managing empyema thoracis in children.
Patients And Methods:
A total of 70 patients aged 1-14 years diagnosed to have empyema thoracis and who underwent tube thoracostomy from January 2010 to December 2013 were studied. All patients of which 12 patients needed decortication.
Results:
The mean age of the study group was 5.44 years and 48.6% were male and 51.4% were female. The most common symptoms at admission were fever (90%), dyspnoea (73%), cough (70%) and chest pain (23%). Pleural fluid cultures were sterile in 60% of patients. The most frequently identified micro-organisms was Staphylococcus aureus (34.2%). Treatment with chest tube drainage was successful in 55 (78.6%) patients. Three patients got expired. Twelve patients had decortications, all of which were successful. The lung re-expansion time was 8.00 ± 1.68 days (range: 5-13 days) in those patients in whom chest tube drainage was successful, whereas it was 7.50 ± 2.623 days (range: 4-14 days) in patients in whom decortication was done. The post-procedure stay was 10.00 ± 1.809 days (range: 7-15 days) in patients with successful chest tube drainage and 9.5 ± 2.902 days (range: 6-17 days) in case of decortication cases.
Conclusion:
Tube thoracostomy should be done in all cases of empyema thoracis regardless of stage, as this leads to reduction in septic load. Decision of decortication should be taken without any delay.
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