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Abstract(s)
Introdução: Pneumotórax é uma patologia pouco comum em idade pediátrica, que pode ocorrer de forma espontânea ou ser adquirido. O tratamento tem como objetivo a resolução do quadro de apresentação e a prevenção da sua recorrência. Apesar da recorrência elevada, o prognóstico destes doentes tende a ser bom.
Objetivos: Realizar revisão casuística de Pneumotórax numa unidade de pneumologia pediátrica; breve revisão da literatura existente sobre o tema.
Material e Métodos: Revisão de processos de doentes internados na Unidade de Pneumologia Pediátrica de um hospital terciáro, com o diagnóstico de Pneumotórax, entre 1 de Janeiro de 2012 e 31 de Dezembro de 2017. Revisão da literatura através de pesquisa na base de dados - Pubmed - e no SciELO e UpToDate.
Resultados: Foram revistos 14 processos correspondentes a 10 doentes, dos quais: Pneumotórax Espontâneo Primário 11 (79%) doentes, Pneumotórax Espontâneo Secundário dois (14%) e Pneumotórax Adquirido em um (7%). Como fatores de risco estavam presentes: duas crianças viviam com progenitores fumadores (20%), uma era prematura (10%), uma tinha diagnostico de asma (10%), duas de FQ (20%) e três de outra doença pulmonar (30%). A dor foi o sintoma referido em 12 doentes (86%), dispneia em cinco (36%) e tosse em quatro (29%). Para confirmar o diagnóstico foi realizada telerradiografia de tórax nas 14 crianças (100%) e em sete (50%) foi realizado posteriormente tomografia computorizada. Todos os doentes efetuaram oxigénio suplementar. Analgesia foi prescrita em 13 (93%), drenagem torácica em oito (57%) e a cirurgia em três (21%), todos episódios de recorrência.
Conclusão: Verificou-se uma sobreposição de atuação entre o observado na população em estudo e o descrito na literatura até à data. A existência de lacunas no conhecimento relativamente à abordagem diagnóstica e terapêutica condiciona alguma controvérsia na abordagem do Pneumotórax.
Introduction: Pneumothorax is an uncommon pathology in pediatric age. It can be spontaneous or acquired. The treatment focus on clinical resolution and preventing the recurrence. Even though there is high recurrence, the prognosis is good. Objectives: Retrospective study of the population at a Pediatric Pulmonology Unit; short review of literature about the subject. Material e Methods: Analysis of the patient’s processes hospitalized at the Pediatric Pulmonology Unit in a tertiary hospital, with diagnosis of Pneumothorax, between 1st of January 2012 and 31st of December 2017. Review of literature by search in database Pubmed – and on SciELO and UpToDate. Results: We analyzed 14 processes corresponding to 10 patients: Primary Spontaneous Pneumothorax occurred in 11 (79%) children, Secondary Spontaneous Pneumothorax in two (14%) and Acquired Pneumothorax in one (7%). There were present the following risk factors: two children lived with parents who smoked (20%), one was preterm (10%), one had a diagnosis of asthma (10%), two had cystic fibrosis (20%) and three had other lung disease's (30%). Pain was reported in 12 children (86%), dyspnea in five (36%) and cough in four (29%). To confirm the diagnosis, chest radiography was performed in 14 children (100%) and in seven (50%) computed tomography was performed later. The most frequent therapy was supplemental oxygen, in 14 (100%). Analgesia was also performed in 13 (93%), thoracic drainage in eight (57%) and surgery in three (21%), all cases that were recurrent episodes. Conclusion: It was verified a correlation between what was done in the studied population and the literature analyzed. However, our knowledge about this pathology has some gaps and sometimes diagnostic and therapeutic approach is not consensual.
Introduction: Pneumothorax is an uncommon pathology in pediatric age. It can be spontaneous or acquired. The treatment focus on clinical resolution and preventing the recurrence. Even though there is high recurrence, the prognosis is good. Objectives: Retrospective study of the population at a Pediatric Pulmonology Unit; short review of literature about the subject. Material e Methods: Analysis of the patient’s processes hospitalized at the Pediatric Pulmonology Unit in a tertiary hospital, with diagnosis of Pneumothorax, between 1st of January 2012 and 31st of December 2017. Review of literature by search in database Pubmed – and on SciELO and UpToDate. Results: We analyzed 14 processes corresponding to 10 patients: Primary Spontaneous Pneumothorax occurred in 11 (79%) children, Secondary Spontaneous Pneumothorax in two (14%) and Acquired Pneumothorax in one (7%). There were present the following risk factors: two children lived with parents who smoked (20%), one was preterm (10%), one had a diagnosis of asthma (10%), two had cystic fibrosis (20%) and three had other lung disease's (30%). Pain was reported in 12 children (86%), dyspnea in five (36%) and cough in four (29%). To confirm the diagnosis, chest radiography was performed in 14 children (100%) and in seven (50%) computed tomography was performed later. The most frequent therapy was supplemental oxygen, in 14 (100%). Analgesia was also performed in 13 (93%), thoracic drainage in eight (57%) and surgery in three (21%), all cases that were recurrent episodes. Conclusion: It was verified a correlation between what was done in the studied population and the literature analyzed. However, our knowledge about this pathology has some gaps and sometimes diagnostic and therapeutic approach is not consensual.
Description
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2019
Keywords
Pneumotórax espontâneo primário Pneumotórax espontâneo secundário Pneumotórax adquirido Pediatria