RESUMO
Pleural empyema is most frequently seen in surgical pathology of the chest at the Hospital del Niño IMAN. Decortication has been necessary, with or without pulmonary resection, in 58% of the cases, contrasting with the limited number of cases in series published in countries with a high standard of life and where a conservative criterion for treatment is held by the authors and some national pediatric groups. Thus, a retrospective analysis is made with 118 patients who underwent surgery between 1971 and 1976 with ages ranging from 3 months to 17 years. The strict management procedure followed in all cases in mentioned, as well as the criterion to perform thoracotomy, to establish the irreversible nature of the anatomical lesions and to evaluate the results. 114 patients were discharged following recovery; 11 of these showed complications such as bronchopleural fistula, atelectasis and postoperative fever, which were treated with pleural drainage and bronchoscopy. Four patients died: one from upper gastrointestinal bleeding and three from sepsis. With the clinical and radiological, as well as the bronchoscopic evaluation, the destructive and irreversible nature of the lesions was determined. This was confirmed by the histopathological study of the resected parts. It is concluded that there should be no doubts or disagreements when surgical treatment is indicated.
