Role of decortication in management of parapneumonic empyema thoracis in children

Background

Parapneumonic empyema thoracis is a rare complication of bacterial pneumonia in children that emencely increases the morbidity. Classically parepneumonic effusions are divided into three stages. Stage I or exudative stage, Stage II or fibrinopurulent stage and stage III or organised effusion stage. The present study was designed to highlight the role of open decortication by thoracotomy in cases of para-pneumonic empyema of stage II and stage III disease in children.

Methods

A prospective observational study was done on 31 children of less than 15 years of age, who presented with stage II and stage III parapneumonic empyema thoracis. They underwent decortication surgery through postero-lateral thoracotomy.

Results

Out of the 31 children included in this study, there were 21 boys (67.74 %) and 10 girls (32.26 %). The average duration of symptoms was 17.84 days. The mean duration of post-operative chest drain was 2.55 days. Staphylococcus aureus was the most frequently encountered organism isolated in culture of fibrino-purulent material from the pleural cavity in 12 cases (38.7 %). Mean duration of total hospital stay was 8.3 days.

Conclusion

Decortication by thoracotomy is a safe and effective approach for stage II & III parapneumonic empyema thoracis in children leading to early recovery and less hospital stay.