RESUMO
Haemoptysis occurs in up to 25 % of young people with Cystic fibrosis (CF) [1]. We undertook a literature review and described the management approach to haemoptysis in CF between 2010 and 2020 at an Australian tertiary paediatric centre, The Children's Hospital Westmead, Sydney, New South Wales, using a retrospective review of the medical records which identified 67 episodes. Sixty episodes met inclusion criteria, including 31 patients. Using the US CF Foundation guidelines, episodes were classified as scant (53.3 %), moderate (38.3 %) or massive (8.3 %). Fifty-two percent of patients were female, mean age at presentation was 15.4 years (SD+/- 2.4) and 58 % were homozygous for the Fdel508 genotype. Twelve episodes (9 patients) required bronchial artery embolization (BAE). BAE was used in all cases of massive haemoptysis 5/5 (100 %), 6/23 (22 %) episodes of moderate and 1/32 (3 %) episode of scant haemoptysis as an elective procedure for recurrent haemoptysis. Our literature review and institutional experience highlights the need for up-to-date management guidelines in the management of haemoptysis in Cystic Fibrosis. Based on our experience, we provide a proposed algorithm to help guide the management of haemoptysis in CF.
Assuntos
Fibrose Cística , Embolização Terapêutica , Criança , Humanos , Feminino , Adolescente , Masculino , Resultado do Tratamento , Hemoptise/etiologia , Hemoptise/terapia , Fibrose Cística/complicações , Fibrose Cística/terapia , Austrália , Embolização Terapêutica/métodosRESUMO
Several conditions presenting in the neonatal and infant period benefit from embolization, including hemangioma, vascular shunts, and tumors. The physiological delicacy and small size of newborns create distinct challenges. This paper discusses embolization of these patients and illustrates the techniques involved.
Assuntos
Embolização Terapêutica/métodos , Embolização Terapêutica/tendências , Radiografia Intervencionista/tendências , Radiologia Intervencionista/tendências , Criança , Humanos , Lactente , Recém-Nascido , Pediatria/tendênciasRESUMO
High-flow priapism is an uncommon entity in the pediatric and adolescent population. It is usually caused by perineal trauma. Here we describe the experience of our institution in this condition over the past 10 years, the various treatment options available, and the successful application of super-selective angiographic embolization as our treatment modality of choice. Included here is the case of a 4-year-old boy (case 3) who, to our knowledge, is the youngest patient described with this condition in the literature.