Article Text

MASSIVE ATELECTASIS IN CHILD WITH ASTHMA
  1. Z Jelcic1,
  2. M Raos1
  1. 1Childrens Hospital Srebrnjak, Zagreb, Croatia

Abstract

Minimal atelectasis, as a complication of asthma, is relatively common. On the other hand massive atelectasis, although rarely seen, could have potential fatal outcome in this disease. The aim of this case report is to show massive atelectasis in an asthmatic 8yearold child who seeks medical help because of asthma exacerbation.

Clinical findings included severe clinical condition, oxygen saturation of 85, dyspnea, respiratory rate 44 per minute, cough, dullness over right hemithorax under percussion and auscultatory absent breath sound. Then the assessed acidbase status was as follows pH 7.38 BE 0.1mmoll HCO3 24.3mmoll pCO2 5.71kPa 02 6.69kPa satO2 0.79.

Spirometry could not be performed, because of severe general condition. Chest radiogram showed atelectasis of right middle and lower lobes, with elevation of right diaphragm and shift of mediastinum and position of heart to right side with compensatory hyperinflation of left hemithorax.

As the possibility of foreign body presence could not be excluded, urgent bronchoscopy was consequently performed and copious amounts of secretion and mucoid plugs were aspirated. Foreign body was not seen.

A postbronchoscopy chest radiogram and general condition oxygen saturation 96 showed significant improvement.

After bronchoscopy, conservative treatment was continued salbutamol, methylprednisolone, physical therapy.

Patient was discharged on 10th day of treatment with normal clinical findings and ventilatory parameters FEV1 and normal chest radiogram. Antiasthmatic therapy has been continued.

The patient regularly attends followup visits and has not had asthma exacerbation since then.

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