[Clinical features and surgery in children with plastic bronchitis].
OBJECTIVE
To review the clinical features and therapeutic experience in children with plastic bronchitis.


METHODS
Fourteen children with plastic bronchitis were reviewed retrospectively, 12 of which were under two years old. The clinical features are characterized by sudden onset, episodes of profound hypoxia and respiratory tract obstruction. SaO2 was between 0.70 and 0.80 even with mask oxygen inhalation. Eight cases were pyretic, 4 cases expectorated jel-like bronchial casts. The chest X-ray picture showed patchy consolidation or atelectasis unilaterally (10 cases) or bilaterally (2 cases). Pulmonary marking thickening and patchy shadow were observed in 2 cases. Twelve cases underwent rigid bronchoscopy and the bronchial casts were removed. Two cases underwent endotracheal intubation.


RESULTS
Eight cases of 12 children received therapeutic bronchoscopy were cured. Other 4 cases had second therapeutic bronchoscopy and bronchial casts were removed again in 3 cases, one died from pulmonary hemorrhage. Two cases who underwent endotracheal intubation died from the multiple organ failure (MOF). Pathologic results showed:the bronchial casts were composed mainly of mucus and fibrin, inflammatory cell infiltrate were observed in 6 cases (Type 1, inflammatory), no cellular infiltrate occurred in 8 cases (Type 2, acellular).


CONCLUSIONS
Plastic bronchitis is a severe and dangerous disease. The branching plastic casts may obstruct part or the entire tracheobronchial, causing respiratory failure. Bronchoscopy and pathologic examination are essential for it's diagnosis and treatment.
Liu
Da-bo
DB
Department of Otorhinolaryngology, Guangzhou Children's Hospital, Guangzhou 510120, China.
Zeng
Qi-yi
QY
Luo
Ren-zhong
RZ
Zhong
Jian-wen
JW
Huang
Zhen-yun
ZY
Zhou
Li-feng
LF
Yang
Yi-yu
YY
Zheng
Yi-nan
YN
D000402:Airway Obstruction; D001991:Bronchitis / Q000209:etiology / Q000473:pathology* / Q000601:surgery*; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D000860:Hypoxia; D007223:Infant; D008297:Male; D001261:Pulmonary Atelectasis; D012189:Retrospective Studies