Management of empyema thoraces in our setup

ABSTRACT

To find out the proper method of management of empyema thoraces to be adopted according to the stage of disease. Prospective study. This study was carried out at Children Hospital Complex, Multan in department of Paediatric Surgery from January 2003 to December 2005 for a period of three years. Fifty patients of post pneumonic empyema thoraces were managed from January 2003 to December 2005. All of them were included in the study. On basis of history, examination and investigations disease was staged as I, II and III. In addition to antibiotics according to culture and sensitivity, intercostals chest tube drainage was performed in all the patients of Stage-I and II. Out of fifty patients thirty four [68%] were male and sixteen [32%] female. Thirty nine [78%] were under 5 years and eleven [22%] of 6-12 years of age. Right side was involved in thirty two [64%] and left side in eighteen [36%]. Twenty nine [58%] were suffering from Stage-I, thirteen [26%] Stage-II and eight [16%] from Stage-Ill. Intercostals chest tube drainage was performed in Stage-I and II. All of the twenty nine [100%] of Stage-I and five out of thirteen [38%] of Stage-II recovered successfully. Thoracotomy was performed in all eight patients of Stage-III straight forward and eight out of thirteen of Stage-II who did not recovered after chest tube drainage. Fifteen out of these sixteen [94%] recovered, one [6%] developed sepsis and expired on 6[th] day after thoracotomy. Tube drainage is very much successful in Stage-I. Early thoracotomy is an excellent option to treat Stage-II and III. Pus drainage facilitative measures are helpful in evacuation of the pus and expansion of lungs