title: CT findings of plastic bronchitis in children after a Fontan operation.
abstract: 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.
authors.affiliation: 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
authors.forename: Hyun Woo
authors.initials: HW
authors.lastname: Goo
authors.forename: Won Kyoung
authors.initials: WK
authors.lastname: Jhang
authors.forename: Young Hwee
authors.initials: YH
authors.lastname: Kim
authors.forename: Jae Kon
authors.initials: JK
authors.lastname: Ko
authors.forename: In Sook
authors.initials: IS
authors.lastname: Park
authors.forename: Jeong-Jun
authors.initials: JJ
authors.lastname: Park
authors.forename: Tae-Jin
authors.initials: TJ
authors.lastname: Yun
authors.forename: Dong-Man
authors.initials: DM
authors.lastname: Seo
mesh_terms: 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*
chemical_list: D003287:Contrast Media