title: [Parapneumonic effussion. A review of 33 cases over 6 years].
abstract: The incidence of empyema thoracis in children seems to be increasing. The objective [corrected] of this study is to propose a rational initial treatment of parapneumonic effusions in order to reduce hospital stay and late-stage empyema complications. Medical records of 33 children presenting parapneumonic effusions who required any surgical therapy between 1997 and 2002 were reviewed. They were grouped as (I) successful management with chest tube, (II) successful management with intrapleural instillation of urokinase and (III) successful surgical treatment: (IIIa) thoracoscopy or (IIIb) thoracotomy.
  
  
  CONCLUSIONS
  Early sonographic evaluation of parapneumonic effusions is usefull to evaluate the severity of disease and the need for surgical intervention. Thoracoscopic-assisted surgery is an effective treatment for pediatric early-stage empyema. Thoracotomy is indicated for most children with established empyema.
authors.affiliation: Servicio de Cirugía Pediátrica, Hospital San Rafael, Madrid.
authors.forename: N
authors.initials: N
authors.lastname: Sanz
authors.forename: P
authors.initials: P
authors.lastname: Aguado
authors.forename: J C
authors.initials: JC
authors.lastname: de Agustín
authors.forename: J M
authors.initials: JM
authors.lastname: Matute
authors.forename: E
authors.initials: E
authors.lastname: Molina
authors.forename: J C
authors.initials: JC
authors.lastname: Ollero
authors.forename: P
authors.initials: P
authors.lastname: Morató
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010996:Pleural Effusion / Q000150:complications* / Q000000981:diagnostic imaging; D011014:Pneumonia / Q000150:complications* / Q000000981:diagnostic imaging; D013902:Radiography, Thoracic; D014463:Ultrasonography