Plastic bronchitis is a rare condition, characterized by the formation of thick mucus plugs that cause airway obstruction. It is seen in a variety of disorders, including congenital cyanotic heart disease following palliative surgery. We describe the case of a 5-year-old child with hypoplastic left-heart syndrome who had undergone a Fontan procedure and developed recurrent bronchial cast formation. These casts were treated aggressively with repeated rigid bronchoscopy and adjuvant medical therapy. We present a brief review of the pathogenesis, treatment options, and description of the challenges involved with endoscopic removal of bronchial casts.
Anteroposterior chest radiograph showing complete right lung opacification preoperatively.
Endoscopic view of the distal trachea, with cast obstructing the right main stem bronchus.
Bronchial cast ramifications. Rule is in centimeters.
Anteroposterior chest radiograph taken after the initial procedure.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Otolaryngology–Head & Neck Surgery editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 2
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Users' Guides to the Medical Literature
The Rational Clinical Examination
Endoscopy is the accepted reference standard test for the patient with dyspepsia as it has both a...
All results at
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.