Pediatric empyema thoracis: our surgical experience

Authors

  • Manisha Albal Department of Pediatric Surgery, NKPSIMS, Nagpur, Maharashtra
  • Prasad Y. Bansod Department of General Surgery, GMC, Nagpur, Maharashtra http://orcid.org/0000-0001-8686-1925
  • Deep Mashru Department of Surgery, NKPSIMS, Nagpur, Maharashtra

DOI:

https://doi.org/10.18203/2349-2902.isj20210976

Keywords:

Empyema thoracis, Pediatric empyema, VATS, Decortication, Open thoracotomy, Fibrinolytic therapy, Intercostal chest tube

Abstract

Incidence of empyema is increasing despite various treatment modalities available. Management of pediatric empyema remains a challenge due to factors like malnutrition, poverty, TB, delay in early intervention and incomplete treatment course. It is necessary to address these issues at ground level. A short 2-year prospective study was carried out at a tertiary care teaching hospital where 17 consecutive cases of pediatric empyema were managed.  Among 17 cases, all patients intercostal tube drainage (ICD) was required. Six patients underwent surgical interventions [2 video-assisted thoracoscopic surgery (VATS) and 4 open thoracotomies] while 11 were managed on ICD and antibiotics. Fibrinolytic therapy was not administered in any case. Follow-up showed good lung expansion with apparent rib crowding in 3 cases and no mortality. Majority of empyema in children are post pneumonic. Chest tube drainage, antibiotics along with intrapleural fibrinolytic is a safe and effective method of treating empyema thoracis in children in resource- poor settings and can reduce the need for invasive interventions.

Author Biographies

Prasad Y. Bansod, Department of General Surgery, GMC, Nagpur, Maharashtra

Assistant Professor, Department of Surgery

Government Medical College & Hospital, Nagpur, Maharashtra, INDIA

Deep Mashru, Department of Surgery, NKPSIMS, Nagpur, Maharashtra

Department of Surgery, NKP Salve institute of Medical sciences, Nagpur

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Published

2021-03-26

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Case Series