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The child with simultaneous stridor and wheezing
S R Poole1, R D Mauro, L L Fan
1Division of Ambulatory Care, University of Colorado School of Medicine, Children's Hospital of Denver 80218.
Pediatric Emergency Care
|March 1, 1990
Summary
Diagnosing simultaneous stridor and wheezing in children can be challenging. Plain x-rays and imaging like barium swallows are crucial for locating airway obstruction caused by congenital, foreign body, or acquired lesions.
Area of Science:
- Pediatric Pulmonology
- Pediatric Otolaryngology
- Pediatric Radiology
Background:
- Simultaneous stridor and wheezing in children often indicate complex airway issues.
- Distinguishing between extrathoracic and intrathoracic causes is critical for diagnosis and management.
- A single or combined airway lesion can present with these symptoms.
Purpose of the Study:
- To analyze the causes and diagnostic methods for simultaneous stridor and wheezing in pediatric patients.
- To evaluate the effectiveness of various imaging techniques in localizing airway obstructions.
Main Methods:
- Retrospective review of 25 pediatric patients with simultaneous stridor and wheezing.
- Inclusion of cases from a children's hospital emergency department and literature review.
- Analysis of diagnostic modalities including plain radiography, barium swallow, and endoscopy.
Main Results:
- Nineteen patients had single airway lesions (9 extrathoracic, 10 intrathoracic); 6 had combined lesions.
- Common causes included congenital lesions (n=8), foreign bodies (n=9), and acquired lesions (n=2).
- Radiography successfully located obstruction in 18 of 25 patients; barium swallow identified vascular rings.
Conclusions:
- Simultaneous stridor and wheezing necessitate a thorough diagnostic approach.
- Imaging, particularly plain x-rays, plays a vital role in identifying the site of airway obstruction.
- Recommendations for the evaluation of pediatric patients with these symptoms are provided.