[Comparative study in the management of pleural effusion]

At the Pediatric Surgery Department of the Hospital de Especialidades of the I.M.S.S. at Puebla, 40 patients with thoracic empyema were studied appreciating some clinical, radiologic and bacteriological variables; they were divided into two groups: 16 cases who had a thoracotomy and decortication and 24 with a conservative management. The hemithorax of the right side was the most affected, and the complications more often seen were the pachypleuritis, pneumatoceles and the persistence of a bronchopleural fistula. The operated group recovered without sequelae, having been hospitalized for 38.9 days average. The second group was discharged around the second week of treatment, without fever or respiratory symptoms even with an "abnormal" X-ray film. Every patient was checked clinically and radiologically every month, noticing, that the pachypleuritis and cysts were disappearing in a progressive way, lasting 6 to 8 months for complete recovery in all of the patients.