Clinical analysis of plastic bronchitis in 7 children

Abstract

Objective To analyze 7 cases of plastic bronchitis in children, review the literature, and improve the understanding of the clinical features, diagnosis and treatment of the disease. Methods Seven children (6 male and 1 female) aged from 2 to 12 years with plastic bronchitis presenting cough, wheezing and dyspnea, who were treated in Nanjing Children's Hospital Affiliated to Nanjing Medical University from Sep.2006 to Mar.2012, were analyzed, respectively.The treatment of the 7 cases included flexible bronchoscopy or rigid bronchoscopy, supplemented by oxygen therapy, antibiotics, and atomizing inhalation. Results All 7 children had acute onset, in which 6 cases presented cough and polypnea, 1 case presented emptysis.With the development of the disease, hypoxemia occurred.The chest X-ray and Computerized Tomography examination showed pulmonary atelectasis in all 7 cases, while atelectasis and emphysema coexisted in 3 cases, pleural effusion in 3 cases.According to the obstructive site, 1 case was in left bronchus and 6 cases in right.One case received rigid bronchoscopy, and 1 case received flexible bronchoscopy after taking rigid bronchoscopy, while 5 cases received flexible bronchoscopy.Five cases were cured after first operation, 2 cases had second flexible bronchoscopy, and endogenous bronchial-shaped casts were removed under bronchoscopy.Pathological results showed the casts were classified as 6 cases of type Ⅰ, inflammatory, and 1 case of type Ⅱ, acellular.Four cases improved markedly, and 3 cases were cured. Conclusions Plastic bronchitis in children is a life-threatening disorder.Flexible bronchoscopy or rigid bronchoscopy extraction of branching plastic casts must be performed urgently for early diagnosis and good therapeutic result. Key words: Plastic bronchitis; Bronchoscopy; Child