Pneumotórax espontâneo em adolescentes observados num Serviço Pediátrico de Urgência

Spontaneous pneumothorax in adolescents observed in Pediatric Emergency Department

Abstract

Objective: To characterize spontaneous pneumothorax (SP) in adolescents observed in Pediatric Emergency Department
(ED). Methods: Retrospective and descriptive study of adolescents admitted to ED due to SP between January 2009 and
December 2011. Demographic data, risk factors, classifi cation of PE, clinical presentation, laboratory tests, therapy and
recurrence were analyzed. Results: Eight adolescents were admitted for PE, with male predominance and ages between
13 and 17 years. The majority had primary PE. In those with secondary PE, 3 cases had asthma and 1 case had smoking
habits. Symptoms began on average 1 day before admission. Chest pain, dyspnea and cough were the commonest.
SP began mostly during rest. All had abnormal auscultatory fi ndings. Respiratory distress was found in one case. Chest
posteroanterior radiograph confi rmed diagnosis, with predominance of high volume and left SP. Oxygenotherapy was
applied in all cases. One patient performed conservative therapy alone. The remaining underwent transthoracic drainage
and 2 cases required suction. 3 cases required surgery in other center, one by persistent air leak and the remaining by
ipsilateral recurrent pneumothorax. One third of the patients needed to be transferred for observation by an unavailable
specialty. With a median follow-up of 13 ± 7.4 months, recurrence of pneumothorax was verifi ed in 37.5% (all ipsilateral) on
average 41 days after diagnosis. Conclusion: In this sample transthoracic drainage was frequently performed, possibly due
to prevalence of high volume SP. It is emphasized the importance of studies about SP in this age group, allowing emergence
of recommendations about appropriate therapy.