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Atelectasis in children.

T S Raman1, S Mathew, Ravikumar

  • 1Department of Pediatrics, Armed Forces Medical College, Pune.

Indian Pediatrics
|April 27, 1999
PubMed
Summary
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Diagnosing pediatric atelectasis is challenging, often requiring imaging and bronchoscopy when clinical signs are insufficient. Early suspicion is key for accurate diagnosis in children with respiratory symptoms.

Area of Science:

  • Pediatric Pulmonology
  • Diagnostic Imaging
  • Interventional Pulmonology

Background:

  • Clinical signs in children with lower respiratory tract symptoms are often insufficient to differentiate conditions like pneumonic consolidation, foreign body aspiration, and atelectasis.
  • Radiology and bronchoscopy are crucial for definitive etiological identification.

Purpose of the Study:

  • To analyze clinical and radiological signs of atelectasis in children with acute and chronic lower respiratory tract symptoms.
  • To evaluate the diagnostic utility of clinical findings, radiological signs, and bronchoscopy in pediatric atelectasis.

Main Methods:

  • Prospective study involving 35 children with acute or chronic lower respiratory tract symptomatology.
  • Clinical assessment for signs like localized loss of breath sounds and mediastinal shift.

Related Experiment Videos

  • Radiological evaluation including assessment for tracheal shift, elevated hemidiaphragm, and silhouette sign.
  • Diagnostic and/or therapeutic bronchoscopy in selected cases.
  • Main Results:

    • Atelectasis was diagnosed in 35 children, with 23 in the acute group and 12 in the chronic group.
    • Clinical recognition of atelectasis was low (8/35).
    • Radiological signs, particularly the silhouette sign (21/35 cases), were important for diagnosing clinically missed atelectasis.
    • Bronchoscopy identified foreign bodies (n=5), mucus plugs (n=4), bronchial narrowing (n=4), and inflammatory secretions (n=8) without major complications.

    Conclusions:

    • Diagnosing atelectasis in children presents challenges.
    • A high index of suspicion is necessary to exclude atelectasis in pediatric patients with respiratory symptoms.
    • Radiological and bronchoscopic evaluations are vital for accurate diagnosis and management.