Vol.102 No.6 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 102 No. 6 June 2009
A Case of Plastic Bronchitis with Cardiopulmonary Arrest
Naoki
Matsushita, Tomoaki Nakano, Go Uemura, Tsunemasa Aiba,
Takeshi Kubo, Makoto Kusuki, Naomi Koshimo and Ayako Hirano
(Osaka City General Hospital)
Plastic bronchitis is characterized by marked obstruction of the large airways by bronchial casts. The condition is rare but can occur at any age. Asthma or allergy is often the cause of cast production, but in some instances there is no etiology identified. Especially in children, it is difficult to differentiate plastic bronchitis from bronchial foreign bodies. Bronchoscopic extraction of casts benefits some patients. Plastic bronchitis causes acute respiratory failure.
A 2-year old boy with no history of asthma or allergy presented with severe respiratory distress following a 3-day history of upper-respiratory-tract infection. Chest X-ray showed complete collapse of the left lung with mediastinal shift. Bronchoscopy demonstrated obstruction of casts. The patient improved after bronchoscopic extraction of casts. But in the emergency care unit, this patient became very difficult to oxygenate despite aggressive ventilation and suddenly developed cardiopulmonary arrest. This patient was recovered by CPR, and a complete cast of the bronchial tree from carina to the small airways was removed by repeated bronchosopies.
Key words :plastic bronchitis, cardiopulmonary arrest, bronchoscopy