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Hemoptysis in children: the hospital for sick children experience
1Department of Otolaryngology, Hospital for Sick Children, Toronto, Ontario.
Insights
In children, infection and trauma are the most frequent causes of hemoptysis (coughing up blood), not vascular issues or tumors. This review highlights common pediatric otolaryngology diagnoses for this symptom.
Area of Science:
- Pediatric Otolaryngology
- Respiratory Medicine
Background:
- Hemoptysis in children is not well-documented in otolaryngology literature.
- Understanding common causes is crucial for accurate diagnosis and management.
Purpose of the Study:
- To identify the most common causes of hemoptysis in pediatric patients presenting to an otolaryngologist.
- To inform otolaryngologists about the etiology of pediatric hemoptysis.
Main Methods:
- Retrospective chart review of pediatric patients with hemoptysis.
- Data collected over a 10-year period at a tertiary pediatric hospital.
- Bronchoscopy performed in the majority of cases to determine etiology.
Main Results:
- Tracheobronchitis (19%) and tracheotomy-related issues (15.5%) were the most common diagnoses.
- Other causes included bronchiectasis, aspiration, pulmonary hemorrhage, foreign bodies, cystic fibrosis, vascular malformations, and infections.
- Infection and trauma were identified as the leading causes, contrary to common perception.
Conclusions:
- Pediatric hemoptysis is frequently caused by infection and trauma.
- Otolaryngologists should consider these common etiologies in their diagnostic approach.
- Vascular anomalies and neoplasms are less common causes of hemoptysis in children.
Abstract:
Causes of hemoptysis in children have not been well documented in the paediatric otolaryngology literature. The aim of this retrospective review is to determine the commonest causes of hemoptysis in the paediatric age group presenting to an otolaryngologist. We reviewed the charts of patients presenting to an otolaryngologist at The Hospital for Sick Children, Toronto, Ontario, over a 10-year period. A total of 37 inpatients beyond the neonatal period were referred for further assessment of hemoptysis. Thirty-two patients (86.5%) underwent bronchoscopy to determine the cause, the hemoptysis resolving spontaneously in the remaining five patients without a diagnosis. Four patients who had a bronchoscopy also had no identifiable pathology. Tracheobronchitis was the commonest diagnosis (19%), followed by tracheotomy-related problems (15.5%) Other causes included bronchiectasis, aspiration of blood, pulmonary hemorrhage, foreign-body aspiration, cystic fibrosis, A-V malformation, tracheobronchial hemangioma, hereditary telangiectasia, laceration of a vocal cord, and pneumonia. Otolaryngologists need to be aware of the etiology of hemoptysis in children. The commonest causes are infection and trauma, and not vascular anomalies or neoplasms as often perceived.