title: [Plastic bronchitis. A case report and review of the literature].
abstract: Plastic bronchitis is a rare complication in which bronchial casts of lymphatic origin develop in the tracheobronchial tree and cause airway obstruction. The main feature is expectoration of bronchial casts. This condition usually occurs in the postoperative period after the Fontan operation for congenital heart disease. Treatment modalities include mucolytics and chest physiotherapy, and in the most severe cases bronchoscopy to remove the casts and aerosolized urokinase or r-TPA. We describe a 12-year-old boy with pulmonary atresia with intact ventricular septum and severely hypoplastic right ventricle who underwent a modified Fontan operation at the age of 7 years. At the age of 12 years the patient started to present frequent episodes of coughing, dyspnea, and desaturation followed by difficult emission of white bronchial casts. An extracardiac Fontan conversion was performed to improve hemodynamics and symptoms. During the postoperative period frequent episodes of airway obstruction required bronchoscopy and finally improved with administration of aerosolized urokinase.
authors.affiliation: Instituto Pediátrico del Corazón, Hospital Universitario 12 de Octubre, Madrid, Spain. mendosa1@eresmas.com
authors.forename: A
authors.initials: A
authors.lastname: Mendoza Soto
authors.forename: L
authors.initials: L
authors.lastname: Galletti
authors.forename: P
authors.initials: P
authors.lastname: Gómez de Quero
authors.forename: María V
authors.initials: MV
authors.lastname: Ramos Casado
authors.forename: J M
authors.initials: JM
authors.lastname: Velasco Bayón
mesh_terms: D001991:Bronchitis / Q000209:etiology*; D002648:Child; D018729:Fontan Procedure / Q000009:adverse effects*; D006801:Humans; D008297:Male