Parapneumonic effussion. a review of 33 cases over 6 years
Sanz, N.; Aguado, P.; de Agustín, J.C.; Matute, J.M.; Molina, E.; Ollero, J.C.; Morató, P.
Cirugia Pediatrica Organo Oficial de la Sociedad Espanola de Cirugia Pediatrica 18(2): 77-82
2005
ISSN/ISBN: 0214-1221 PMID: 16044644 Document Number: 592181
The incidence of empyema thoracis in children seems to be increasing. The objective of this study is to propose a rational initial treatment of parapneumonic effusions in order to reduce hospital stay and late-stage empyema complications. Medical records of 33 children presenting parapneumonic effusions who required any surgical therapy between 1997 and 2002 were reviewed. They were grouped as (I) successful management with chest tube, (II) successful management with intrapleural instillation of urokinase and (III) successful surgical treatment: (IIIa) thoracoscopy or (IIIb) thoracotomy. Early sonographic evaluation of parapneumonic effusions is usefull to evaluate the severity of disease and the need for surgical intervention. Thoracoscopic-assisted surgery is an effective treatment for pediatric early-stage empyema. Thoracotomy is indicated for most children with established empyema.