Hemoptysis In Children Research Articles

Hemoptysis in children.

Definition Hemoptysis is defined as coughing up of blood or the presence of blood in sputum. It is not a common symptom in children and although not usually life-threatening, it can become so. Massive hemoptysis is defined as bleeding that exceeds 8 mL/kg per 24 hours. Because children younger than 6 years of age tend to swallow their sputum, they rarely present with hemoptysis, unless the bleeding is substantial. Epidemiology and Etiology Causes of hemoptysis in children are listed in Table 1. Acute lower respiratory tract infection is the single most common cause, accounting for approximately 40% of cases. Hemoptysis that ranges from blood-tinged sputum to massive quantities of blood in the sputum is relatively common among those who have cystic fibrosis (CF). Massive hemoptysis is estimated to occur in 5% of CF patients, but approximately 1% will have mild hemoptysis every year, most commonly among those who are older than 18 years. In bronchiectasis due to causes other than CF, the incidence of hemoptysis is approximately 10% to 15%. Foreign body aspiration remains a leading cause of hemoptysis in children, with the majority of cases occurring in those younger than 4 years of age. Hemoptysis seldom is encountered in those who have primary pulmonary tuberculosis; it is estimated to occur in fewer than 1% of cases.

Hemoptysis in Children

Definition Hemoptysis is defined as coughing up of blood or the presence of blood in sputum. It is not a common symptom in children and although not usually life-threatening, it can become so. Massive hemoptysis is defined as bleeding that exceeds 8 mL/kg per 24 hours. Because children younger than 6 years of age tend to swallow their sputum, they rarely present with hemoptysis, unless the bleeding is substantial. Epidemiology and Etiology Causes of hemoptysis in children are listed in Table 1. Acute lower respiratory tract infection is the single most common cause, accounting for approximately 40% of cases. Hemoptysis that ranges from blood-tinged sputum to massive quantities of blood in the sputum is relatively common among those who have cystic fibrosis (CF). Massive hemoptysis is estimated to occur in 5% of CF patients, but approximately 1% will have mild hemoptysis every year, most commonly among those who are older than 18 years. In bronchiectasis due to causes other than CF, the incidence of hemoptysis is approximately 10% to 15%. Foreign body aspiration remains a leading cause of hemoptysis in children, with the majority of cases occurring in those younger than 4 years of age. Hemoptysis seldom is encountered in those who have primary pulmonary tuberculosis; it is estimated to occur in fewer than 1% of cases.

Fibrous histiocytoma of the trachea: management of a rare cause of upper airway obstruction

We describe a case of fibrous histiocytoma of the trachea diagnosed in a 17-year-old female who presented with symptoms of ‘asthma’. Management included rigid bronchoscopy with biopsy and debulking of this obstructing tumor, later excised with partial tracheal resection. Although tracheal tumors are quite rare in children, the majority ( 6 9 ) of reported cases of fibrous histiocytoma of the trachea have been described in the pediatric age group. The possibility of a tracheal neoplasm as a cause of wheezing, stridor or hemoptysis in children should be recognized. Control of the airway without tracheotomy may facilitate surgical cure via tracheal resection in such cases.

Hemoptysis in Children

Hemoptysis is rare in children, yet is one of the most frightening manifestations of cardiopulmonary disease. A wide spectrum of diseases has been reported to cause hemoptysis in children, but the search for a specific cause can be tedious and unrewarding. Early diagnosis and interventions of hemoptysis are extremely important for the successful management of this potentially lethal process in children.From July 1994 to June 1996, 15 pediatric patients ranging from 1 month to 15 years of age were admitted to the Pulmonology division for the investigation of hemoptysis. We retrospectively reviewed the clinical records and diagnostic evaluations of these patients.Six (40%) of the patients investigated were infectious in origin, only one patient had tuberculous infection. Three patients had a traumatic cause and 2 patients had foreign bodies in the airway. Two cases had no obvious contributing cause of hemoptysis despite extensive investigations. One patient had hematemesis because bleeding from esophageal ulcerations was misinterpreted as hemoptysis. One patient had varicosed tracheal and bronchial collaterals causing massive hemoptysis due to portal vein obstruction and hypertension.Pulmonary infection was the leading cause of hemoptysis in the 15 children we studied, but Mycobacterium tuberculosis is an uncommon causative agent. Bronchoscopy is an extremely useful tool for the diagnosis and localization of hemoptysis. Hematemesis may be misinterpreted as hemoptysis, particularly when an accurate history is not possible in children, therefore, bleeding from the upper aerodigestive tract should be studied meticulously and excluded adequately using endoscopy.

Lung Pathology and Hemoptysis in Children

Lung Pathology and Hemoptysis in Children