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Pediatric lower airway conditions: Clinical
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Let’s start with foreign body aspiration, which is where young toddlers might get something like a small coin or a peanut, lodged in their respiratory tract.
Most of the time, the foreign body goes into the right mainstem bronchus because it’s wider and more vertical than the left.
In general, if the blockage affects a larger airway or causes a more complete blockage of an airway, then it causes more severe symptoms.
Typically, children have a sudden onset of shortness of breath, along with coughing, gagging, choking, or drooling.
On auscultation, breath sounds are diminished in blocked area.
If there’s partial obstruction of the extrathoracic portion of the trachea, that can cause inspiratory stridor.
If there are no sounds like this on auscultation, it may be because there’s a complete obstruction of an airway.
Objects like coins and batteries are radiopaque, and will be visible. Whereas objects like a piece of food are radiolucent, so they don’t show up.
Fortunately, there are still indirect signs of the obstruction that can be seen on a chest Xray. In a complete obstruction, there’s atelectasis distal to the obstruction.
In a partial obstruction, there’s focal hyperlucency and reduced pulmonary markings distal to the obstruction, due to air trapping. In other words, the foreign body acts like a one way valve that allows air to enter, but not escape.
If there’s a lot of air trapping, it can cause a mediastinal shift away from the affected side.
Pediatric lower airway conditions are the disorders that affect children's trachea, bronchi, bronchioles, or lungs. Common examples include foreign body aspiration, asthma, bronchiolitis, croup, and pneumonia. These conditions can cause symptoms such as cough, wheezing, shortness of breath, and difficulty breathing. Treatment depends on the specific condition and may include medications, breathing therapies, and in some cases, surgery.
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