Current indications for decortication in the treatment of empyema in children

Robert P. Foglia, Judson Randolph

Research output: Contribution to journalArticle

56 Scopus citations

Abstract

Although most children with empyema respond to antibiotics and pleural drainage, a recognizable number fail to improve. This study reviews experience with ten children over the past 7 years who have been selected for lung decortication for refractory empyema. Decortication was performed because of lack of clinical improvement despite drainage and multiple antibiotics during an average 20-day preoperative hospitalization. Responsible organisms included β-hemolytic Streptococcus, Streptococcus pneumoniae, and Hemophilus influenzae. A computerized tomographic (CT) scan of the chest was performed in the last eight patients and showed at least a 50% limitation of lung expansion by the products of the empyema in each case. Following decortication, chest tubes were removed, antibiotics stopped, and temperature and white blood cell count returned promptly to normal. The advantages of early decortication in selected patients with empyema who do not respond to antibiotics and drainage include low morbidity, shorter hospitalization, and excellent long-term results.

Original languageEnglish (US)
Pages (from-to)28-33
Number of pages6
JournalJournal of Pediatric Surgery
Volume22
Issue number1
DOIs
StatePublished - Jan 1987

Keywords

  • Childhood empyema
  • pulmonary decortication

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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