During a period of 13 years from 1970 to 1983, 38 patients have been treated for thoracic empyema (non-tuberculous) at the Kobe Children's Hospital. Seventeen patients were treated by serial thoracenteses and 28, including 7 children without improvement by thoracenteses, by an insertion of a chest tube. Two patients have undergone decorication and right upper lobectomy respectively, after unsuccessful chest tube drainage. There was no death in this series. The group treated by an insertion of a chest tube as the primary therapy has provided the best result with earlier subsidence of fever and improvement in the x-ray findings. In a long term follow up, a thick peel observed at the end of therapy has become unremarkable several years after. The observation in this series provides a auggestion that an insertion of a chest tube is the choice of initial treatment, and once the symptoms subside, a spontaneous resolution of the pleural peel can be expected in several years.
