Clinical Spectrum and Outcome of Empyema in Nepalese Children

Bhatta, Narendra; Singh, Anita; Kalakheti, Balkrishna; Khanal, Basudha; Shrestha, PN; Singh, Rajinder

doi:10.3126/jnps.v28i2.1387

Cited by 2 publications

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“…A previous study from our institute showed that almost 18% of patients with empyema thoracis failed conservative management with tube thoracostomy, and required surgical intervention. 7 However, there was then no dedicated thoracic surgery at our centre and most children were managed elsewhere up to 2016. There are few data on the clinical profile and outcomes of surgical intervention for late-stage empyema thoracis in children in our population.…”

Section: Discussionmentioning

confidence: 99%

“…Natural orifice transluminal endoscopic surgery (NOTES) has been predicted to replace conventional laparoscopy in the near future. [1][2][3][4][5][6][7][8][9][10] In addition, the transvaginal route, having typical physical and physiological benefits, [1][2][3][4][5][6][11][12][13][14][15][16] makes it the safest, as well as an immensely popular method. [1][2][3]6,[11][12][13][14][15][17][18][19][20][21][22][23][24][25][26] However, even a decade after its inception, it continues to be fraught with diverse technical hurdles such as spatial constraints, inadvertent vaginal gas-leak, compelling requirements for complex instrumentation, scarce availability and affordability, and a steep learning curve, to name a few.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3]6,[11][12][13][14][15][17][18][19][20][21][22][23][24][25][26] However, even a decade after its inception, it continues to be fraught with diverse technical hurdles such as spatial constraints, inadvertent vaginal gas-leak, compelling requirements for complex instrumentation, scarce availability and affordability, and a steep learning curve, to name a few. 7,[13][14][15][16][17][18][19][20] Gas leaks from the vaginal…”

Section: Introductionmentioning

confidence: 99%

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Open pleural decortication for the late stage empyema thoracis in children: a retrospective observational study from a tertiary hospital of eastern Nepal

et al. 2020

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The management of late-stage empyema thoracis requires surgical intervention. We performed a retrospective descriptive analysis of open pleural decortication for late stage empyema thoracis in 55 children (age ≤ 15 years; median age = 6 years; age range = 1–15 years; 40 [72.7%] boys) over 42 months. The median time to thoracotomy from the onset of symptoms was 24 days, and the median duration of hospital stay before and after surgery was 15 and 4 days, respectively. Three (5.5%) patients had necrotising pneumonia, requiring debridement; 4 (7.3%) patients had superficial surgical site infection; 12 (21.8%) patients had perioperative pus culture positive for bacteria; and 3 (5.5%) patients had tubercular aetiology. There was no operative mortality. At median follow-up of 18 months, all patients are in good general health. Open pleural decortication leads to rapid resolution of symptoms and reduces hospital stay in paediatric late-stage empyema thoracis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Open pleural decortication for the late stage empyema thoracis in children: a retrospective observational study from a tertiary hospital of eastern Nepal

et al. 2020

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Pleural Effusion in Children: How often do we suspect Tubercular origin?

Shrestha

Rayamajhi

1970

J. Nepal Paedtr. Soc.

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Introduction: Pleural effusion is a common problem in children; mostly due to common causes like pyogenic or tubercular infections. Different studies have showed that about 30%-60% of pleural effusion have resulted into formation of empyema. Method: This was an observational study done in children aged 3 months to 14 years with a diagnosis of pleural effusion admitted at Kanti Children’s Hospital, Maharajgunj from August 2009 to March 2010. The aim of the study was done to find out different modalities of treatment for the same and their outcome. A detailed clinical history and physical examination, was done in all children. Chest x-ray, laboratory reports and treatment were recorded and all patients followed up until death or discharge. Any change of management was also noted. Pleural effusion caused by nephritic syndrome or congestive cardiac failure were excluded from the study. Results: During the study period of eight months, 64 patients were admitted with the diagnosis of pleural effusion. Boys to girls ratio was 2:1. Right-sided pleural effusions were more common than left sided pleural effusions (53% vs. 37%). Most of patients improved with parental antibiotics along with chest tube drainage (62%). One in three patients (31%) received anti-tubercular drugs. Three patients (4.6%) were referred to surgeon for decortications and one patient (1.6%) died. Conclusion: Though chest tube drainage with parental antibiotics was the mainstay of treatment of pleural effusion, however one-third of patients also received anti-tubercular drugs. Key words: Pleural effusion; pyogenic; decortication; adenosine deaminase (ADA). DOI: 10.3126/jnps.v30i3.3914J Nep Paedtr Soc 2010;30(3):132-134Introduction: Pleural effusion is a common problem in children; mostly due to common causes like pyogenic or tubercular infections. Different studies have showed that about 30%-60% of pleural effusion have resulted into formation of empyema. Method: This was an observational study done in children aged 3 months to 14 years with a diagnosis of pleural effusion admitted at Kanti Children’s Hospital, Maharajgunj from August 2009 to March 2010. The aim of the study was done to find out different modalities of treatment for the same and their outcome. A detailed clinical history and physical examination, was done in all children. Chest x-ray, laboratory reports and treatment were recorded and all patients followed up until death or discharge. Any change of management was also noted. Pleural effusion caused by nephritic syndrome or congestive cardiac failure were excluded from the study. Results: During the study period of eight months, 64 patients were admitted with the diagnosis of pleural effusion. Boys to girls ratio was 2:1. Right-sided pleural effusions were more common than left sided pleural effusions (53% vs. 37%). Most of patients improved with parental antibiotics along with chest tube drainage (62%). One in three patients (31%) received anti-tubercular drugs. Three patients (4.6%) were referred to surgeon for decortications and one patient (1.6%) died. Conclusion: Though chest tube drainage with parental antibiotics was the mainstay of treatment of pleural effusion, however one-third of patients also received anti- tubercular drugs. Key words: Pleural effusion, pyogenic, decortication, adenosine deaminase (ADA). DOI: 10.3126/jnps.v30i3.3914J Nep Paedtr Soc 2010;30(3):132-134

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Clinical Spectrum and Outcome of Empyema in Nepalese Children

Abstract: Keywords: Empyema; chest tube drainage, decorticationDOI = 10.3126/jnps.v28i2.1387J. Nepal Paediatr. Soc. Vol.28(2) 2008 p.49-51

Cited by 2 publications

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Open pleural decortication for the late stage empyema thoracis in children: a retrospective observational study from a tertiary hospital of eastern Nepal

Open pleural decortication for the late stage empyema thoracis in children: a retrospective observational study from a tertiary hospital of eastern Nepal

Pleural Effusion in Children: How often do we suspect Tubercular origin?

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