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Master Thesis

Étiologies et prise en charge des épanchements péricardiques chez l’enfant : analyse rétrospective d’une cohorte grenobloise entre 2012 et 2016

Abstract : Purpose: Few studies describe characteristics of pericardial effusion or tamponade in pediatric population. The purpose of this study was to describe the etiology and management of pericardial effusion managed in a polyvalent pediatric hospital. Methods: All children under 18 years of age diagnosed with pericardial effusion in a pediatric center in Grenoble, between 2012 and 2016 were retrospectively enrolled. Results: 61 patients (39 girls) with a mean age of 8,1 years (0-17,8 yo) were included. 42 patients were symptomatic including 9 cardiac tamponade. Pericardial effusion measured less than 10 mm in 39 patients and more than 20 mm in one child. Various etiologies were identified: viral or idiopathic 24%, mental anorexia 16%, malignancy 10%, bacterial infection 10%, post thoracotomy 8%, post pericardiotomy 8%, uremia 7%, pulmonary arterial hypertension (PAH) 5%, autoimmune disease 5%, traumatic 5%, heart failure 2%.Treatments used antiinflammatory drugs in 31% and targeted specific etiology in the remaining 69% of chidren.Drainage or pericardiocentesis was performed in 14 (23%) children for altered hemodynamic status. Risk factors for drainage were traumatic etiology and effusion size. No other clinical or biological parameters were predictive of drainage. After a mean follow-up of 1,4 years, 4 patients died, 3 have recurrent pericarditis, 6 had still chronic effusion. None developed pericardial constriction. Conclusion: Various etiologies of pericardial effusion are found in pediatric population as in the adult one. Need for drainage is quite frequent, especially in case of altered hemodynamic status, large pericardial effusion or traumatic cause, that seems to be more specific in children.
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Master Thesis
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Charlotte Jeanne Denise Couturier. Étiologies et prise en charge des épanchements péricardiques chez l’enfant : analyse rétrospective d’une cohorte grenobloise entre 2012 et 2016. Médecine humaine et pathologie. 2017. ⟨dumas-01613137⟩

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