Abstract

An empyema is the accumulation of purulent fluid in the pleural cavity and complicates pneumonia in 1 of 150 affected children. Symptoms include shortness of breath, fever, dry cough and chest pain. Aims: To evaluate the management of empyema thoracis in children in the COVID era. Methods: We retrospectively reviewed all the patients in our Department admitted between December 2020 to May 2023 who were diagnosed with empyema thoracis and surgically intervened. Results: 22 children with empyema thoracis were treated. All the patients had parapneumonic effusion treated with parenteral antibiotics and chest tube insertion initially but symptoms did not subside. Pre operative imaging included Chest X ray in all the cases and HRCT chest in 16 cases. Four of them underwent Video Assisted Thoracoscopic Surgery (VATS) out of which 2 required conversions to open thoracotomy and 18 patients underwent open thoracotomy primarily. First post operative Chest X Ray was done on POD 1. Chest tubes were removed on post operative day (POD)-4 for VATS and POD 6 for open thoracotomy. One patient treated with VATS and two with Open thoracotomy developed small bronchopleural fistula which was managed conservatively. One patient for whom VATS was converted to open thoracotomy had to undergo prolonged ventilation and expired. Follow up was done for all the discharged patients, all of whom were symptom free and suffered no recurrence.

Description