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Does Video Assisted Thoracoscopic Surgery Help To Cure Pleural Effusion?
Question: hello sir
my son age 4years got treatment for pnemonia and then he is getting pain in right side chest,Dr advised for USG,USG chest showed a small collection of 50-60ml with mild Pleural thickening.And fever is reapeting and Dr advised for VATs. i want to know is it right surgery?
my son age 4years got treatment for pnemonia and then he is getting pain in right side chest,Dr advised for USG,USG chest showed a small collection of 50-60ml with mild Pleural thickening.And fever is reapeting and Dr advised for VATs. i want to know is it right surgery?
Brief Answer:
VATS is a surgery of choice for effusion
Detailed Answer:
Hi....I have just now gone through your query. I understand that your son has got pneumonia and now is getting complicated by fluid accumulation around the lung - technically called pleural effusion.
VATS - Video Assisted Thoracoscopic Surgery us done to drain and also prevent recurrence of fluid accumulation. Due its simplicity, safety, and efficacy, VATS pleural evacuation can be recommended as the initial intervention in pediatric parapneumonic effusions and empyema in patients who do not require emergent drainage.
In your case 50-60ml us not a volume to be drained on emergency basis. So you can go ahead with VATS. But 50-60ml fluid has got a fair chance to resolve by itself with antibiotic treatment itself too.
Regards - Dr. Sumanth
VATS is a surgery of choice for effusion
Detailed Answer:
Hi....I have just now gone through your query. I understand that your son has got pneumonia and now is getting complicated by fluid accumulation around the lung - technically called pleural effusion.
VATS - Video Assisted Thoracoscopic Surgery us done to drain and also prevent recurrence of fluid accumulation. Due its simplicity, safety, and efficacy, VATS pleural evacuation can be recommended as the initial intervention in pediatric parapneumonic effusions and empyema in patients who do not require emergent drainage.
In your case 50-60ml us not a volume to be drained on emergency basis. So you can go ahead with VATS. But 50-60ml fluid has got a fair chance to resolve by itself with antibiotic treatment itself too.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr,
attached are the reports from previous and current doctor’s prescription:
hospital doctors didn’t prescribed/gave any medicine post discharge mentioning that the condition is severe and immediate drainage is required, could you please look at the reports and let me know if that is the case? current doctor (Dr Mr Panth) wanted to see if this can be cured with medicine and given a 10day course , attached is the prescription. please let me know are we in the right direction? Is it possible to make decision quickly if the medicine is effective than waiting for 10 days, my worry is that it may worsen the situation if the medicine is not working effectively, could you please advise if any tests we need in-between during the medicine course to track the progress? based on your opinion, is it advisable to go for operative procedure (Drainage) right now? if so based on the current condition which would be the best? currently the patient is discharged from hospital and under medication, could you please tell me when and based on what symptoms we need to rush to hospital i.e. what are the symptoms that indicate it’s an emergency? Doctor advised for blood test to for TB, is it normally the case?
attached are the reports from previous and current doctor’s prescription:
hospital doctors didn’t prescribed/gave any medicine post discharge mentioning that the condition is severe and immediate drainage is required, could you please look at the reports and let me know if that is the case? current doctor (Dr Mr Panth) wanted to see if this can be cured with medicine and given a 10day course , attached is the prescription. please let me know are we in the right direction? Is it possible to make decision quickly if the medicine is effective than waiting for 10 days, my worry is that it may worsen the situation if the medicine is not working effectively, could you please advise if any tests we need in-between during the medicine course to track the progress? based on your opinion, is it advisable to go for operative procedure (Drainage) right now? if so based on the current condition which would be the best? currently the patient is discharged from hospital and under medication, could you please tell me when and based on what symptoms we need to rush to hospital i.e. what are the symptoms that indicate it’s an emergency? Doctor advised for blood test to for TB, is it normally the case?
Brief Answer:
Suggestions on pleural effusion
Detailed Answer:
Hi...coming to your queries directly -
1. I think you are in the right direction.
2. If the medicine is working well the best proof is that the fever will be down and under control. Reappearance of fever is not good.
3. You can take an ultrasound chest and decide on the fluid content.
4. If it is reducing no need to go for a surgical procedure.
Danger signs when you need to rush to hospital -
1. Severe breathlessness.
2. High grade fever returning.
3. Lips and finger tips turning blue.
I do not think about TB in such a short duration fever.
Regards - Dr. Sumanth
Suggestions on pleural effusion
Detailed Answer:
Hi...coming to your queries directly -
1. I think you are in the right direction.
2. If the medicine is working well the best proof is that the fever will be down and under control. Reappearance of fever is not good.
3. You can take an ultrasound chest and decide on the fluid content.
4. If it is reducing no need to go for a surgical procedure.
Danger signs when you need to rush to hospital -
1. Severe breathlessness.
2. High grade fever returning.
3. Lips and finger tips turning blue.
I do not think about TB in such a short duration fever.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Will it affect in future if we don't drain/remove and treat it with medicine (water n puss)? I.e. if it dries out and gets deposited there ? Any food restrictions? Current doctor said no to non-veg and fruits. Currently, temperature is below 100 , do we need to give medication for fever? Its repeating with these temperatures below 100 for every approx 9 hours. ADA blood test result is having serum 85, what does it mean ? Do we need to worry? What should be the course of action?
Regards,
XXXX
Will it affect in future if we don't drain/remove and treat it with medicine (water n puss)? I.e. if it dries out and gets deposited there ? Any food restrictions? Current doctor said no to non-veg and fruits. Currently, temperature is below 100 , do we need to give medication for fever? Its repeating with these temperatures below 100 for every approx 9 hours. ADA blood test result is having serum 85, what does it mean ? Do we need to worry? What should be the course of action?
Regards,
XXXX
Brief Answer:
Suggestoins on pleural fluid
Detailed Answer:
Hi...
1. Medical treatment is as good a s surgical treatment - do not worry.
2. If it dries out and gets deposited that means it is getting deposited and surgery is indicated. But as you say the kid is still having temperature (if it is more than 100-102), I suggest you go ahead with VATS.
3. No food restriction - all fruits and non-veg can be given.
4. Fever needs to be treated, only if temperature is more than 100F.
5. Temperature less than 100 is not fever in kids.
6. The average serum ADA in TB patients is 20.88 (±5.97). But as the value is 85 I suggest you do the XpertMTB Rifa test in the pleural fluid and blood and then confirm if it is TB or not.
Regards - Dr. Sumanth
Suggestoins on pleural fluid
Detailed Answer:
Hi...
1. Medical treatment is as good a s surgical treatment - do not worry.
2. If it dries out and gets deposited that means it is getting deposited and surgery is indicated. But as you say the kid is still having temperature (if it is more than 100-102), I suggest you go ahead with VATS.
3. No food restriction - all fruits and non-veg can be given.
4. Fever needs to be treated, only if temperature is more than 100F.
5. Temperature less than 100 is not fever in kids.
6. The average serum ADA in TB patients is 20.88 (±5.97). But as the value is 85 I suggest you do the XpertMTB Rifa test in the pleural fluid and blood and then confirm if it is TB or not.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr.,
After medication,The current CT scan and report is shared,Doctor said there is minor infection but can be cured with medicne priscribed.Could you please let me know your opinion? Is everything ok as per scan report?
And When is it advisable to take Vaccine?
After medication,The current CT scan and report is shared,Doctor said there is minor infection but can be cured with medicne priscribed.Could you please let me know your opinion? Is everything ok as per scan report?
And When is it advisable to take Vaccine?
Brief Answer:
Please answer the questions below
Detailed Answer:
Hi...
Before answering your queries - I have a few questions -
1. How is the fever?
2. How is the kid's appetite and hunger?
3. Is there any breathlessness?
4. Is the kid still in hospital or at home?
Kindly get back to me with answers and I will be glad to help you.
Regards - Dr. Sumanth
Please answer the questions below
Detailed Answer:
Hi...
Before answering your queries - I have a few questions -
1. How is the fever?
2. How is the kid's appetite and hunger?
3. Is there any breathlessness?
4. Is the kid still in hospital or at home?
Kindly get back to me with answers and I will be glad to help you.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
1. Fever is under control, the XXXXXXX temperature observed was around 96 since he got discharged from hospital and being treated with medication, it has been 8 days since we started medication course. this temperature too is not frequent.
2. as usual, since he got discharged from hospital, and with the medication he has been eating normally.
3. since day one there was no issue with breathing, he is breathing normally.
4. he is being treated at home with medication which i have enclosed earlier, please have a look at those.
Also, do let me know what type of dose of vaccination we should go for, one doctor said 1 dose and other said 3 and 4 dose, let me know your opinion as which suits the best and effective.
do let know your observations on the reports and questions submitted earlier.
Regards,
XXXX
1. Fever is under control, the XXXXXXX temperature observed was around 96 since he got discharged from hospital and being treated with medication, it has been 8 days since we started medication course. this temperature too is not frequent.
2. as usual, since he got discharged from hospital, and with the medication he has been eating normally.
3. since day one there was no issue with breathing, he is breathing normally.
4. he is being treated at home with medication which i have enclosed earlier, please have a look at those.
Also, do let me know what type of dose of vaccination we should go for, one doctor said 1 dose and other said 3 and 4 dose, let me know your opinion as which suits the best and effective.
do let know your observations on the reports and questions submitted earlier.
Regards,
XXXX
Brief Answer:
Suggestions on vaccines and drugs
Detailed Answer:
Hi...coming to your queries -
1. Vaccination - I suggest you give him - 1 dose of Prevenar 13 and 2 doses of Influenza vaccine (each dose a month apart).
2. Observation - overall he is improving - but if the problem recurs - he might require early VATS this time.
3. The prescription seems to be fine - but you have come out against medical advice.
Regards - Dr. Sumanth
Suggestions on vaccines and drugs
Detailed Answer:
Hi...coming to your queries -
1. Vaccination - I suggest you give him - 1 dose of Prevenar 13 and 2 doses of Influenza vaccine (each dose a month apart).
2. Observation - overall he is improving - but if the problem recurs - he might require early VATS this time.
3. The prescription seems to be fine - but you have come out against medical advice.
Regards - Dr. Sumanth
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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