Etiology and Management of Pediatric Hemoptysis

Batra, Pete S.; Holinger, Lauren D.

doi:10.1001/archotol.127.4.377

Cited by 63 publications

(68 citation statements)

References 24 publications

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“…The differential diagnosis between hemoptysis and hematemesis is relatively simple starting from alkaline or acidic pH of the bloodcontaining sputum. The difference was well described recently, 11,14 but it seems that differential diagnosis between hemoptysis/pulmonary hemorrhage and extrapulmonary bleeding requires further clarification.…”

Section: Researchmentioning

confidence: 86%

Pediatric Pulmonary Hemorrhage vs. Extrapulmonary Bleeding in the Differential Diagnosis of Hemoptysis

Vaiman

Klin

Rosenfeld

et al. 2017

cajgh

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Introduction: Hemoptysis is an important symptom which causes a major concern, and warrants immediate diagnostic attention. The authors compared a group of patients with pediatric pulmonary hemorrhage with pediatric patients diagnosed with extrapulmonary bleeding focusing on differences in etiology, outcome and differential diagnosis of hemoptysis. Methods: We performed the retrospective analysis of medical charts of 134 pediatric patients admitted to the Emergency Department because of pulmonary and extrapulmonary hemorrhage and were diagnosed with suspected hemoptysis or developed hemoptysis (ICD10-CM code R04.2). The cases with pulmonary hemorrhage (Group 1) were compared with cases of extrapulmonary bleeding (Group 2) using the Fisher Exact test or Pearson's χ 2 test for categorical variables. The t-test was used to assess differences between continuous variables of the patients in the two groups. Results: Bloody cough was the presenting symptom in 73.9% of cases. 30 patients had pulmonary hemorrhage (Group 1), while 104 patients had extrapulmonary bleeding (Group 2). The underlying causes of bleeding in Group 2 included epistaxis, inflammatory diseases of nasopharynx and larynx, foreign bodies, gingivitis, and hypertrophy of adenoids. Mortality rate was 10% in Group 1, whereas Group 2 did not have any mortality outcomes during the observation period. Etiologycal factors were significantly different between hemoptysis and extrapulmonary bleeding in children Conclusions: Our research suggested that pulmonary and extrapulmonary bleeding are two conditions that differ significantly and cannot be unified under one diagnostic code. It is important to differentiate between focal and diffuse cases, and between pulmonary and extrapulmonary hemorrhage due to the diversity of clinical courses and outcomes.

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Section: Researchmentioning

confidence: 86%

Pediatric Pulmonary Hemorrhage vs. Extrapulmonary Bleeding in the Differential Diagnosis of Hemoptysis

Vaiman

Klin

Rosenfeld

et al. 2017

cajgh

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“…Daha önce yapılmış çalışmalarda çocuklarda hemoptizi nedenleri arasında %17.5-25 oranında bildirilmiştir (8,14). Düzeltici cerrahi uygulanan olgularda hemoptizi riskinin belirgin olarak azaldığı bildirilmiştir (13). Literatürde özellikle Fontan prosedürü uygulanan hipoplastik sol kalpli olgular ya da triküspit atrezisi olan çocuklarda yıllar sonra masif hemoptizi görüldüğü çeşitli olgu sunumların-da bildirilmiştir (8,(15)(16)(17).…”

Section: Discussionunclassified

Hemoptysis in Children: Sometimes Petty Sometimes Scary

Eyüboğlu¹,

Aslan²

2016

Turkish J Pediatr Dis

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ÖzETAmaç: Hemoptizi nadir görülen ancak bazen hayatı tehdit eden, solunum sistemi kaynaklı kanamadır. Hemoptizi altta yatan neden ne olursa olsun hastayı, aileyi ve hekimi tedirgin eden bir durumdur. Hemoptizi nedenleri ırklara, yaşanılan bölgelere ve çalışma yöntemlerine göre değişiklik gösterebilir. Hemoptizi ile başvuran çocukların etiyolojilerinin gözden geçirilmesi amaçlanmıştır. Gereç ve Yöntemler:Çocuk Göğüs Hastalıkları polikliniğine hemoptizi nedeniyle başvuran hastalar etiyoloji, tedavi ve takip açısından retrospektif olarak gözden geçirildi. Bulgular:Hemoptizi yakınması ile başvuran 69 hastanın ortalama yaşı 12.3±4.2 yıldı. Hemoptizinin en sık nedeni olarak 13 hastada (%18) solunum yolu enfeksiyonları görüldü. Daha sonra psödohemoptizi nedeni olan gastrointestinal kanama, burun kanaması ve gingivostomatitdi. Bu hastaların öykülerinde kanamayla beraber öksürük tarif etmesinin tanı açısından karışıklık oluşturduğu görüldü. Hastaların öykü ve fizik muayene bulgularına göre %37'sinde invaziv olmayan tetkikler ile tanı konulurken, %30'unda endoskopi, bronkoskopi ve anjiyografi gibi invaziv tetkikler gerekmiştir.Sonuç: Etiyolojide çok fazla hastalık olduğu göz önünde bulundurulursa hemoptizi yakınması ile başvuran çocuklarda iyi öykü almak, çocuk ve aile ile iyi iletişim kurmak ve ayrıntılı fizik muayene yapmak tanıda oldukça yol gösterici olmakta, bazı hastalarda ise ayrıntılı ve invaziv tetkikler ile tanı koyulabilmektedir. Anahtar Sözcükler: Çocuk, Etiyoloji, HemoptiziABSTRAcT Objective: Hemoptysis is the rare but potentially life-threatening bleeding of the respiratory system. Whatever the underlying cause of hemoptysis, it causes anxiety in patients, families and physicians. Causes of hemoptysis may vary according to the race, region and research methodology. In this study we aimed to review the etiology of hemoptysis in children. Material and Methods:Patients presenting with hemoptysis were evaluated retrospectively in terms of hemoptysis etiology, treatment and follow-up at a tertiary pediatric pulmonology department. Results:Sixty-nine patients presented with the complaint of hemoptysis, and the mean age was 12.3±4.2 years. The most common cause of hemoptysis, seen in 13 patients (18%), was respiratory tract infections. Gastrointestinal bleeding, epistaxis, and gingivostomatitis were among causes of pseudohemoptysis while a history of coughing with the bleeding caused diagnostic confusion in these patients. According to the patient's history and physical examinations, noninvasive procedures were used in 37% and invasive procedures such as bronchoscopy, endoscopy and angiography in 30% of the patients for the diagnosis.conclusion: Considering the number of diseases in the etiology of hemoptysis, a detailed medical history, physical examination and good communication with the child and parents may help the diagnosis while some patients need detailed and invasive procedures.

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“…Massive hemoptysis is defined as bleeding that exceeds 8 ml/kg per 24 hours (or .200 ml over a 24-h period) (1,2). Hemoptysis is a rare phenomenon in children; it occurs most commonly in the setting of acute lower respiratory infections (e.g., pneumonia, pulmonary abscess).…”

Section: Discussionmentioning

confidence: 99%

A Case of Tracheal Varices in an Adolescent Patient with Cyanotic Heart Disease

et al. 2013

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Tracheal varices and bronchial varices are infrequently reported in adults as a complication of an underlying vascular obstruction, including portal hypertension, pulmonary arterial hypertension, or pulmonary venous hypertension. Tracheal varices and bronchial varices have been reported in adults with failing Fontan physiology, but this occurrence is rare in children. We report the unusual presentation of tracheal-bronchial varices due to veno-venous collaterals in an adolescent patient with Glenn physiology for doubleinlet left ventricle and portal hypertension secondary to cardiac cirrhosis. We document complete resolution of these varices after heart and liver transplantation.

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Etiology and Management of Pediatric Hemoptysis

Cited by 63 publications

References 24 publications

Pediatric Pulmonary Hemorrhage vs. Extrapulmonary Bleeding in the Differential Diagnosis of Hemoptysis

Pediatric Pulmonary Hemorrhage vs. Extrapulmonary Bleeding in the Differential Diagnosis of Hemoptysis

Hemoptysis in Children: Sometimes Petty Sometimes Scary

A Case of Tracheal Varices in an Adolescent Patient with Cyanotic Heart Disease

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