Management of pneumothorax in children

Background. The efficacy of tube thoracostomies inserted at the sixth inter costal space at midaxillary line was evaluated retrospectively in children. Methods. Ninety-seven children with pneumothorax, treated by tube thoracost omy were taken into the study. There were 67 male and 30 female patients wi th 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 t he left in 38 (39.1%) of the cases. Bilateral pneumothorax was found in 9 a dditional patients (9.2%). All patients were treated with tube thoracostomy placed in the pleural cavity at the sixth intercostal space at the mid-axi llary line. Postoperative course was uneventful and no complication was enc ountered at any of the patients. Conclusions. On the basis of these data we suggest that all thoracostomy tu bes should be inserted on the sixth intercostal space where both air and th e accumulating fluid can be reached. The insertion of the thoracostomy tube at the second intercostal space must be avoided since it carries a high ri sk of subclavian vein injury in small children, and also a secondary tube i s frequently required to drain the accompanying intrapleural fluid.