Pericarditis in Childhood; Evaluation of Etiology, Diagnosis and Management of 47 Cases

Etiology, diagnose and management of patients with pericardial disease who were diagnosed at the Çukurova University, Department of Pediatric Cardiology, between 1993- 1996 were evaluated retrospectively. There were 27 male and 20 female cases ages ranged from seven days and 14 years (mean 7.23 ± 4.95 years). Etiologies of the disease were purulent pericarditis in 12 cases, uremic pericarditis in six, collagen tissue disorders in five, malignancy in four cases, rheumatic fever and hpothyroidism in two each, Down syndrome and post-pericardiotomy syndrome in one each. In six patients, pericardial effusion considered as due to viral pericarditis. Etiologic factor was not diagnosed in two cases. Diagnostic and/or therapeutic pericardiocentesis was performed 31 times to 27 cases. Twelve of these cases were needed surgical intervention after pericardiocentesis (tube drainage, partial pericardiectomy or pericardio-plevral window). Four patients were undergone surgical intervention directly. Percutaneous pericardial catheter drainage was performed at the time of pericardiocentesis in three cases, and intrapericardial drug administration was performed by this way in one case. Nine patients were died; four of them had purulent pericarditis, two had uremic, one had malign pericardial effusion, one had heart failure and one had viral pericarditis. It is concluded that purulent pericarditis is the most common etiologic reason of pericarditis in region and mortality rate is very high (% 33) because the patients admitted to hospital late. Therapeutic approach is changing usually due to etilogy of disease and clinical status of the patient so any steady protocol could not be established in patients with pericardial diseases. Percutaneous pericardial catheter drainage is an alternative method to surgery in suitable cases.