CT findings of plastic bronchitis in children after a Fontan operation.
BACKGROUND
Plastic bronchitis is a rare cause of acute obstructive respiratory failure in children. Life-threatening events are much more frequent in patients with repaired cyanotic congenital heart disease, and most frequent following a Fontan operation. Commonly, the diagnosis is not made until bronchial casts are expectorated. Detailed CT findings in plastic bronchitis have not been described.


OBJECTIVE
To describe the CT findings in plastic bronchitis in children after a Fontan operation.


METHODS
Three children with plastic bronchitis after a Fontan operation were evaluated by chest CT. Bronchial casts were spontaneously expectorated and/or extracted by bronchoscopy. Airway and lung abnormalities seen on CT were analyzed in the three children.


RESULTS
CT demonstrated bronchial casts in the central airways with associated atelectasis and consolidation in all children. The affected airways were completely or partially obstructed by the bronchial casts without associated bronchiectasis. The airway and lung abnormalities rapidly improved after removal of the bronchial casts.


CONCLUSIONS
CT can identify airway and lung abnormalities in children with plastic bronchitis after a Fontan operation. In addition, CT can be used to guide bronchoscopy and to monitor treatment responses, and thereby may improve clinical outcomes.
Goo
Hyun Woo
HW
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-2 dong, Songpa-gu, Seoul, South Korea. hwgoo@amc.seoul.kr
Jhang
Won Kyoung
WK
Kim
Young Hwee
YH
Ko
Jae Kon
JK
Park
In Sook
IS
Park
Jeong-Jun
JJ
Yun
Tae-Jin
TJ
Seo
Dong-Man
DM
D001991:Bronchitis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000628:therapy; D001999:Bronchoscopy; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D018729:Fontan Procedure / Q000009:adverse effects*; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media