Pulmonary Air Leak Syndrome Associated with Respiratory Disease in Infancy and Childhood

ABSTRACT

PURPOSE: Pneumothorax, pneumomediastinum and subcutaneous emphysema rarely complicate pediatric respiratory disease such as bronchial asthma, bronchiolitis, bronchopneumonia. But physicians unfamiliar with natural history of these complications may feel that surgical intervention is necessary. So this study was done to to recognize the pulmonary air leak syndrome associated with respiratory disease in infancy and childhood. METHODS: I reviewed retrospectively the medical records and X-ray films of 6 patients with air leak syndromes associated with respiratory disease in the department of pediatrics, Soonchunhyang Chunan hospital, during the 2 year 3months from January, 1994 to April, 1996. RESULTS: 1) Among 2861 patients, pulmonary air leak syndrome were observed in 6 patients. Pulmonary air leak syndromes were seen in 4 patients among 501 patients with bronchial asthma, 1 patient among 106 patients with lobar pneumonia, 1 patient among 969 patients with bronchopneumonia. 2) Among 6 patients, 4 patients were bronchial asthma, 1 patient was lobar pneumonia and 1 patient was bronchopneumonia. 3) Concerning the location of pulmonary air leak syndrome, pneumothorax, pneumomediastinum, subcutaneous emphysema were observed in one case (Table 1, case 2), both pneumomediastinum and subcutaneous emphysema were observed in two cases (Table 1, case 1, 4). In three cases, only one of pneumothorax, pneumomediastinum and subcutaneous emphysema was observed (Table 1, case 3, 5, 6). 4) When the predisposing disease was bronchial asthma, the occurrance of pulmonary air leak syndrome was noted in first attack. 5) All of the cases improved with conservative treatment and two cases of pneumothorax was recieved closed thoracotomy. 6) All patients improved without any sequelae and there were no recurrance. CONCLUSIONS: Pulmonary air leak syndrome such as pneumothorax, pneumomediastinum, subcutaneous emphysema is rarely complicated pediatric respiratory diseases. The most common respiratory disease is bronchial asthma.