Total pleurectomy as the surgical treatment for recurrent secondary spontaneous pneumothorax in a child with severe pulmonary Langerhans cells histiocytosis

Pulmonary Langerhans cell histiocytosis (LCH) in children is more extensive and is a rare cause of spontaneous secondary pneumothorax (SSP) which tends to be recurrent and refractory to conventional treatment. Its occurrence in paediatric patients posed great challenge to the choice of surgical mana...

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Bibliographic Details
Published in:BMJ Case Reports 2011, Vol.2011
Main Authors: Abdul Aziz, Dayang Anita, Abdul Rahman, Nur Afdzillah, Tang, Swee Fong, Abdul Latif, Hasniah, Mohd Zaki, Faizah, Mohd Annuar, Zulfiqar, Alias, Hamidah, Abdul Latiff, Zarina
Format: Report
Language:English
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Summary:Pulmonary Langerhans cell histiocytosis (LCH) in children is more extensive and is a rare cause of spontaneous secondary pneumothorax (SSP) which tends to be recurrent and refractory to conventional treatment. Its occurrence in paediatric patients posed great challenge to the choice of surgical management. Surgery in the form of pleurodesis is only considered if SSP does not improve after chemotherapy and after considering all relevant risk and benefits of surgery to patients. Chemical pleurodesis will not give the expected effect to eradicate SSP in this patient. Therefore mechanical pleurodesis is the treatment of choice. There are various techniques to perform mechanical pleurodesis; from pleural abrasion to pleurectomy. In the authors’ experience, bilateral total pleurectomy provided the best outcome for this 9-year-old patient with persistent respiratory distress from SSP due to extensive pulmonary LCH.
ISSN:1757-790X
DOI:10.1136/bcr.09.2011.4734