Affiliations: Department of Pediatric and Congenital Cardiothoracic Surgery, Levine Children's Hospital, Charlotte, NC, USA | Department of Pediatric Pulmonology, Levine Children's Hospital, Charlotte, NC, USA | Department of Pediatric General Surgery, Levine Children's Hospital, Charlotte, NC, USA
Note: [] Corresponding author: Kristin Lang, PA-C, Department of Pediatric and Congenital Cardiothoracic Surgery, Levine Children's Hospital, 1000 Blythe Blvd, Charlotte, NC 28203, USA.
Abstract: Plastic bronchitis is a condition in which large, rubber-like, bronchial casts develop in the tracheobronchial tree causing airway obstruction. It is an unusual disorder that occurs in various disease states. Most case reports of plastic bronchitis associated with congenital heart disease are in patients palliated with Fontan physiology. We describe a 13-year-old girl with DiGeorge syndrome and truncus arteriosus who underwent an uneventful truncal valve replacement. The child developed plastic bronchitis on postoperative day eight requiring extra-corporeal membrane oxygenation support and daily bronchoscopy to remove bronchial casts. Our patient did not have elevated systemic venous pressures or Fontan physiology. We speculate the etiology of plastic bronchitis may have been surgical trauma to the lymphatic channels surrounding the bronchi and disruption of pleural adhesions. A comprehensive evaluation revealed no specific cause and the diagnosis of idiopathic plastic bronchitis was made.
