[Analysis of incidence and clinical picture of pneumothorax in children].

UNLABELLED

Although pneumothorax has been thoroughly described since the beginning of 19th century there are few studies investigating its epidemiology in pediatric patients. The aim of this study was to evaluate incidence and clinical picture of pneumothorax in pediatric patients.

MATERIALS AND METHOD

A retrospective review of medical records of all patients treated in the Department of Pediatric Pulmonology, Allergy and Clinical Immunology of Karol Marcinkowski Medical University from January 1999 to December 2008 with the diagnosis of pneumothorax. Data analyzed include anthropometric parameters, present comorbidities, clinical presentation, treatment, length of hospital stay as well as presence and type of complications.

RESULTS

27 episodes of pneumothorax in 21 patients were treated in the given period. There were 52% of episodes of spontaneous primary pneumothorax, 37% of secondary spontaneous pneumothorax and 11% of pneumothorax due to non-penetrating trauma. 59% of patients were males. Presenting symptoms included dyspnoe (59%), chest pain (48%) and cough (44%). 74% of cases required treatment with chest tube drainage: 80% episodes of primary spontaneous pneumothorax, 67% episodes of non-penetrating trauma pneumothorax and 71% episodes of secondary spontaneous pneumothorax. Mean time of chest tube drainage was 6.2 +/- 5.1 days: 4.5 +/- 0.7 days for non-penetrating trauma pneumothorax, 5.7 +/- 6.4 days for secondary and 7.2 +/- 1.4 days for primary spontaneous pneumothorax. Chest tube drainage was successful in 80% of cases. 4 patients were referred to thoracic surgeons. One child was treated with chemical pleurodesis. Mean hospital stay was 22.2 +/- 13.7 days: 11.1 +/- 0.7 days for patients with non-penetrating trauma pneumothorax and 29.7 +/- 1.4 days for patients with spontaneous secondary pneumothorax.

CONCLUSIONS

Primary and secondary spontaneous pneumothorax is a rare event in children and the majority of patients are male. Secondary spontaneous pneumothorax is a complication of underlying chronic pulmonary conditions, most frequently cystic fibrosis and pulmonary infections. Children presenting with spontaneous secondary pneumothorax tended to be younger and required longer hospital stay.