Hemoptysis in children : single center experience

Abstract EN

Objective : To review the causes of hemoptysis in children presenting to the respiratory department at King Hussein Medical Center.

Methods : A retrospective chart review of all children who presented with hemoptysis was conducted from 1st April 2002 to 1st April 2012.

Diagnosis of pulmonary hemorrhage was based on radiological and bronchoscopic findings.

Demographic data, age at presentation, number of attacks, and presence of another diagnosis were recorded.

Radiological and laboratory data were included as well.

Results : A total of 60 children with 68 episodes of hemoptysis were reviewed.

Diffuse pulmonary hemorrhage was seen in five patients, three of them had idiopathic pulmonary hemorrhage, one had celiac disease and another had Wagener disease.

Of the 55 patients with localized pulmonary hemorrhage the most common cause was cystic fibrosis (30 %) and congenital heart disease (27 %), followed by pulmonary arteriovenous malformation (8 %), ruptured hydatid cysts (7.3 %) and retained foreign body (5.4 %).

Fifty one out of the 55 (92.7 %) with localized hemorrhage had localized patch on the chest x-ray; 40 % had previous x-ray within the previous two years showing the same radiological patch at the time of hemoptysis episodes.

Massive hemoptysis was found in three patients.

Diagnostic flexible bronchoscopy was done in all patients within one week of the episode of hemoptysis.

High resolution chest CT-scan was done for all patients with the diffuse type.

Dynamic chest CT-scan was done in 50 % of patients with localized hemorrhage.

Embolization was done in five patients with AV malformation and two patients with cystic fibrosis.

Surgical lobectomy was done in those with sequestration, hydatic cyst and one patient with foreign body and another one with localised bronchiectasis.

Conclusion : Hemoptysis is not uncommon in children.

As an entity it should always be thoroughly investigated.

Etiology differs according to age.

Idiopathic pulmonary hemorrhage still constitutes a major group.