Management of pneumothorax in children.

BACKGROUND

The efficacy of tube thoracostomies inserted at the sixth intercostal space at midaxillary line was evaluated retrospectively in children.

METHODS

Ninety-seven children with pneumothorax, treated by tube thoracostomy were taken into the study. There were 67 male and 30 female patients with a mean age of 6.5 years (range 1 days to 15 years)

RESULTS

Pneumothorax was located at the right side in 50 (51.5%), and at the left in 38 (39.1%) of the cases. Bilateral pneumothorax was found in 9 additional patients (9.2%). All patients were treated with tube thoracostomy placed in the pleural cavity at the sixth intercostal space at the mid-axillary line. Postoperative course was uneventful and no complication was encountered at any of the patients.

CONCLUSIONS

On the basis of these data we suggest that all thoracostomy tubes should be inserted on the sixth intercostal space where both air and the accumulating fluid can be reached. The insertion of the thoracostomy tube at the second intercostal space must be avoided since it carries a high risk of subclavian vein injury in small children, and also a secondary tube is frequently required to drain the accompanying intrapleural fluid.