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Percutaneous drainage of chest abscesses in children
W S Ball1, G S Bisset, R B Towbin
1Department of Radiology, University of Cincinnati College of Medicine, OH.
Insights
Percutaneous drainage effectively treated intrathoracic abscesses in pediatric patients. This minimally invasive approach resolved mediastinal and lung abscesses without requiring surgery.
Area of Science:
- Thoracic Surgery
- Pediatric Interventional Radiology
- Infectious Disease Management
Background:
- Intrathoracic abscesses in children can arise from esophageal issues or intrapulmonary infections.
- Management often involves complex surgical procedures, carrying significant risks.
Purpose of the Study:
- To evaluate the efficacy of percutaneous drainage for pediatric intrathoracic abscesses.
- To determine if minimally invasive drainage can obviate the need for surgery.
Main Methods:
- Percutaneous catheter drainage was performed on eight intrathoracic abscesses in seven pediatric patients (ages 3-18).
- Abscesses included five mediastinal/paramediastinal and three intrapulmonary locations.
Main Results:
- All eight abscesses resolved completely following percutaneous drainage.
- Mean catheter drainage duration was 28 days for mediastinal/paramediastinal abscesses and 19-24 days for intrapulmonary abscesses.
- No patient required surgical intervention (thoracotomy or wedge resection).
Conclusions:
- Percutaneous drainage is a safe and effective treatment for pediatric intrathoracic abscesses.
- This technique offers a viable alternative to surgery, particularly for mediastinal and intrapulmonary collections.
Abstract:
Seven patients ranging in age from 3 to 18 years underwent percutaneous drainage of eight intrathoracic abscesses. Five of the abscesses were mediastinal or paramediastinal and resulted from esophageal perforation or esophageal anastomotic leakage. The abscesses resolved in each case, with a mean catheter drainage time of 28 days and no need for surgical intervention. Three of the abscesses were intrapulmonary, and each lay adjacent to a pleural surface. All three lung abscesses resolved within 19-24 days, without thoracotomy or wedge resection.