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Flexible Bronchoscopic Findings and Therapeutic Effects in Atelectasis of Children

Journal of the Korean Pediatric Society 2002;45(9):1090-1096.
Published online September 15, 2002.
Flexible Bronchoscopic Findings and Therapeutic Effects in Atelectasis of Children
Mee Yong Shin, Jong Hee Hwang, Eun Hee Chung, Jeong Hee Moon, Ju Suk Lee, Yong Min Park, Kang Mo Ahn, Sang Il Lee
Department of Pediatrics, Sungkyunkwan University, School of Medicine, Samsung Medical Center, Seoul, Korea
소아 무기폐에서 굴곡성 기관지내시경 소견 및 치료적 유용성
신미용, 황종희, 정은희, 문정희, 이주석, 박용민, 안강모, 이상일
성균관대학교 의과대학 삼성서울병원 소아과
Correspondence: 
Kang Mo Ahn, Email: kmaped@smc.samsung.co.kr
Abstract
Purpose
: We evaluated the clinical manifestations, bronchoscopic findings and therapeutic effects of flexible fiberoptic bronchoscopy in atelectasis of children.
Methods
: Sixty six children who received bronchoscopy due to persistent atelectasis, acute severe atelectasis and incidental atelectasis on plain chest radiography were studied retrospectively.
Results
: The most common causative underlying disease was pneumonia(60.4%). Other underlying conditions were pulmonary tuberculosis, chronic lung disease, postoperative state, bronchial asthma and chest trauma. The most common abnormal findings were inflammatory changes such as bronchial stenosis(n=15), mucosal edema and large amount of secretion(n=14), granulation tissue(n=3) and mucus plug(n=3) although 39.4% showed normal airways. Other findings were congenital airway anomalies, endobronchial tuberculosis, extrinsic compression and obstruction by blood clot. In 32 children with pneumonia-associated atelectasis, 43.7% revealed normal airways, and the most common abnormal findings were also inflammatory changes. Eighteen out of 39 patients who received therapeutic intervention such as suctioning of secretion, bronchial washing and intrabronchial administration of N-acetylcysteine(Mucomyst ) had complete or partial resolution of their atelectasis. In 32 patients with pneumonia-associated atelectasis, 56.5% showed improvement by therapeutic intervention.
Conclusion
: In this study, atelectasis was mainly associated with inflammatory airway diseases such as pneumonia. The most common abnormal bronchoscopic findings were inflammatory changes such as mucosal edema and large amounts of secretion and bronchial stenosis, although about 40% revealed normal airway. Flexible bronchoscopy is helpful for either diagnosis or treatment, especially in pneumonia-associated atelectasis.
Key Words: Atelectasis, Flexible fiberoptic bronchoscopy


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