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Ann Thorac Surg 2006;81:1482-1484
© 2006 The Society of Thoracic Surgeons

Case report

Management of Multiple Tension Pneumatoceles Refractory to Tube Thoracostomy Decompression

En-Ting Wu, MD a , Jin-Shing Chen, MD, PhD b , *

a Department of Pediatrics, National Taiwan University Hospital Taipei, Taiwan
b Department of Surgery, National Taiwan University College of Medicine, Taipei, Taiwan

Accepted for publication May 9, 2005.

* Address correspondence to Dr Chen, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung Shan South Road, Taipei, Taiwan (Email: cjs{at}ha.mc.ntu.edu.tw).

A 10-month-old boy had multiple tension pneumatoceles develop 4 weeks after pneumonia with parapneumonic empyema caused by methicillin-resistant Staphylococcus aureus. The pneumatoceles failed to completely respond to tube thoracostomy drainage, and sudden onset of cardiopulmonary collapse occurred after induction of anesthesia. He was rescued by multiple percutaneous venous catheter decompressions, followed by lobectomy. Our experience showed that surgery remains the definitive treatment for pediatric patients with multiple tension pneumatoceles. However, extra caution should be taken in the preoperative management of these patients, even in the presence of tube thoracostomy.






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