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[Pleural empyema in childhood]
1Kinderchirurgische Klinik, Klinikum Mannheim, Fakultät für Klinische Medizin, Universität Heidelberg, Mannheim.
Langenbecks Archiv Fur Chirurgie. Supplement II, Verhandlungen Der Deutschen Gesellschaft Fur Chirurgie. Deutsche Gesellschaft Fur Chirurgie. Kongress
|January 1, 1989
Insights
Pediatric empyema, a rare complication, is typically managed with antibiotics and chest tube drainage. Surgical intervention like decortication is reserved for empyemas linked to lung malformations.
Area of Science:
- Pediatric Pulmonology
- Thoracic Surgery
- Infectious Diseases
Context:
- Empyema is an uncommon but serious parapneumonic complication in children.
- Traditional management has shifted from early surgical intervention to less invasive methods.
Purpose:
- To review the current management strategies for pediatric empyema.
- To highlight indications for surgical intervention in specific cases.
Summary:
- Antibiotics and closed-tube thoracostomy drainage are the primary treatments for pediatric empyema, even in anaerobic infections.
- Decortication is rarely recommended, with a few exceptions for specific underlying conditions.
- Empyemas associated with congenital lung malformations, such as lobar emphysema or cystic lung, necessitate surgical treatment.
Impact:
- This approach optimizes treatment for most pediatric empyema cases.
- It emphasizes the importance of surgical consideration for empyemas stemming from structural lung abnormalities.
- Improves outcomes by guiding appropriate, timely interventions for pediatric empyema.
Abstract:
Empyema is a rare parapneumonic complication in children. The use of antibiotics and closed-tube thoracostomy drainage has superseded operative procedures like decortication even in anaerobic infections. Only a few authors still recommend early decortication. However empyemas based on malformations such as lobar emphysema or cystic lung should be treated surgically.