Introduction Thoracic empyema is an infrequent complication of appendicitis that has rarely been reported in the literature. Case Presentation and Review of the Literature The case of a 11-year-old boy who was admitted for medical management of an appendicular mass is presented. His clinical course was complicated by the development of an appendicular abscess and an extensive right-sided empyema. A comprehensive review of the literature was conducted including the most representative cases. The data were collected and analyzed by two independent investigators. Ten cases were found. Most patients were young individuals (mean age: 25.1 years; male : female ratio: 0.5). Risk factors for thoracic empyema included pregnancy (10%) and age (60%). The most frequent organisms isolated were Escherichia coli, Bacteroides spp., and Klebsiella spp. The survival rate was 100%. Conclusion Thoracic empyema should be considered a potential cause of respiratory distress in patients with appendicitis. Furthermore, the abdomen should be carefully evaluated as a source of infection in patients with thoracic empyema without an underlying lung disease.
A 5 month old boy with long-gap esophageal atresia (EA) with proximal tracheoesophageal fi stula (TEF) was transferred from an outside hospital with signifi cant respiratory distress. During that hospitalization, treatment included surgical repair of the EA and TEF by Foker procedure, TEF ligation, and primary end-to-end esophageal anastomosis. Th e patient subsequently developed a mid-esophageal stricture refractory to through-the-scope balloon dilation over the course of the following year as the patient experienced symptoms and stenosis relapse shortly aft er each successful dilation.
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