title: [Clinical features and surgery in children with plastic bronchitis].
abstract: 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.
authors.affiliation: Department of Otorhinolaryngology, Guangzhou Children's Hospital, Guangzhou 510120, China.
authors.forename: Da-bo
authors.initials: DB
authors.lastname: Liu
authors.forename: Qi-yi
authors.initials: QY
authors.lastname: Zeng
authors.forename: Ren-zhong
authors.initials: RZ
authors.lastname: Luo
authors.forename: Jian-wen
authors.initials: JW
authors.lastname: Zhong
authors.forename: Zhen-yun
authors.initials: ZY
authors.lastname: Huang
authors.forename: Li-feng
authors.initials: LF
authors.lastname: Zhou
authors.forename: Yi-yu
authors.initials: YY
authors.lastname: Yang
authors.forename: Yi-nan
authors.initials: YN
authors.lastname: Zheng
mesh_terms: 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