Conservative Management of Non-Tension Pneumothorax Following Drainage of Pleural Empyema.

Pleural empyema is a recognized complication of pneumonia and causes significant morbidity in children. Insertion of a small-bore chest drain shortens hospital admission but can be associated with pneumothorax. This is usually assumed to be caused by a bronchopleural fistula or a displaced drain and therefore under pressure, requiring surgical intervention. We describe two children who developed a pneumothorax after a large empyema was drained. Both children were clinically stable and the pneumothorax was not under pressure. They were managed conservatively with complete resolution after 3-6 months. By highlighting these cases, we hope to stop other children undergoing unnecessary surgery.