Abstract
The most common nontraumatic pediatric emergency is the patient with an acute pulmonary infection. In this regard, it is important to differentiate viral from bacterial infections, but a problem usually arises when one has to deal with atelectasis associated with viral infections. Asthma is the next most common nontraumatic thoracic emergency, and the problem usually is exacerbation of asthma with or without an associated pulmonary infection. In this regard, bacterial infections do not trigger asthma attacks, but viral infections do. After asthma, endobronchial foreign bodies are next most common; the key to their detection lies in the use of inspiratory-expiratory film sequences. Hydrocarbon aspiration also is common in childhood and manifests primarily in bilateral basilar infiltrates. Spontaneous pneumothorax is uncommon in childhood, but it is becoming increasingly apparent that one can encounter unexpected entities such as delayed congenital diaphragmatic hernia and delayed congenital lobar emphysema in older infants and children. Finally, among the more common causes of vascular congestion in childhood are acute glomerulonephritis and, less often, myocarditis.
Similar content being viewed by others
References
Khamapirad T, Glezen WP. Clinical radiographic assessment of acute lower respiratory tract disease in infants children. Semin Resp Infect 1977;2:130–44.
Swischuk LE. Emergency imaging of the acutely ill or injured child. 3rd ed. Baltimore: Williams & Wilkins, 1994;146–50.
Swischuk LE, Hayden CK. Viral vs. bacterial pulmonary infections in children (is roentgenographic differentiation possible?) Pediatr Radiol 1986;16:278–84.
Wildin SR, Chonmaitree T, Swischuk LE. Roentgenographic features of common pediatric viral respiratory tract infections. Am J Dis Child 1988;142:43–6.
Eriksson J, Nordshus T, Carlsen KH, Orstadvik I, Westvik J, Eng J. Radiological findings in children with respiratory syncytial virus infection: relationship to clinical bacteriological findings. Pediatr Radiol 1986;16:120–2.
Simpson W, Hacking PM, Court SDM, Gardner PS. The radiological findings in respiratory syncytial virus infection in children. II. The correlation of radiological categories with clinical virological findings. Pediatr Radiol 1974;2:155–60.
Griscom NT, Wohl MEB, Kirkpatrick JA Jr. Lower respiratory infections: how infants differ from adults. Radiol Clin North Am 1978;16:367–87.
Guckel C, Benz-Bohm G, Widemann B. Mycoplasma pneumonias in childhood: roentgen features, differential diagnosis, review of the literature. Pediatr Radiol 1989;19:499–503.
Putman CE, Curtis AMcB, Simeone JF, Jensen P. Mycoplasma pneumoniae: clinical roentgenographic patterns. AJR Am J Roentgenol 1975;124:417–22.
Rose RW, Ward BH. Spherical pneumonias in children simulating pulmonary mediastinal masses. Radiology 1973;106:179–82.
McIntosh K, Ellis EF, Hoffman LS, Lybass TG, Eller JJ, Fulginiti VA. The association of viral bacterial respiratory infections with exacerbations of wheezing in young asthmatic children. J Pediatr 1973;82:578–90.
Mitchell I, Inglis H, Simpson H. Viral infection in wheezy bronchitis asthma in children. Arch Dis Child 1976;51:707–11.
Bierman CW. Pneumomediastinum and pneumothorax complicating asthma in children. Am J Dis Child 1967;114:42–50.
Jorgensen J, Falliers C, Bukantz S. Pneumothorax mediastinal subcutaneous emphysema in children with bronchial asthma. Pediatrics 1963;31:824–32.
McSweeney WJ, Stempel DA. Non-iatrogenic pneumomediastinum in infancy childhood. Pediatr Radiol 1973;1:139–44.
Reed MH. Radiology of airway foreign bodies in children. J Can Assoc Radiol 1977;28:111–18.
Seibert RW, Seibert JJ, Williamson SL. The opaque chest: when to suspect a bronchial foreign body. Pediatr Radiol 1986;16:193–6.
Svedstrom E, Puhakka H, Kero P. How accurate is chest radiography in the diagnosis of tracheobronchial foreign bodies in children? Pediatr Radiol 1989;19:520–2.
Capitanio MA, Kirkpatrick JA. The lateral decubitus film, aid in determining airtrapping in children. Radiology 1972;103:460–2.
Landay MJ, Christensen EE, Bynum LJ. Pulmonary manifestations of acute aspiration of gastric contents. AJR Am J Roentgenol 1978;131:587–92.
Mendelson CL. The aspiration of stomach contents into the lungs during obstetric anesthesia. Am J Obstet Gynecol 1946;52:191–204.
Hunter TB, Whitehouse WM. Freshwater near drowning: radiological aspects. Radiology 1974;112:51–6.
Kirkpatrick JA, Fleisher DS. Roentgen appearance of chest in acute glomerulonephritis in children. J Pediatr 1964;64:492–8.
MacPherson RI, Banerjee AJ. Acute glomerulonephritis: a chest film diagnosis? J Can Assoc Radiol 1974;25:58–64.
Berman L, Stringer D, Ein SH, Shandling B. The late presenting pediatric Bochdalek hernia: a 20-year review. J Pediatr Surg 1988;23:735–9.
Brill PW, Gershwin ME, Krasna IH. Massive gastric enlargement with delayed presentation of congenital diaphragmatic hernia: report of three cases and review of the literature. J Pediatr Surg 1977;12:667–74.
Gaisie G, Young LW, Oh KS. Late onset Bochdalek’s hernia with obstruction: radiographic spectrum of presentation. Clin Radiol 1983;34:267–70.
Kirchner SG, Burko H, O’Neill JA, Stahlman M. Delayed radiographic presentation of congenital right diaphragmatic hernia. Radiology 1975;115:155–6.
MacPherson RI. “Acquired” congenital diaphragmatic hernia. J Pediatr Surg 1977;12:657–66.
Mandell GA, Bellah RD, Boulden ME, Sherman NH, Harcke HT, Padman RJ, McNicholas KW. Cervical trachea: dynamics in response to herniation of the normal thymus. Radiology 1993;186:383–6.
Swischuk LE. Vomiting blood for three days. Pediatr Emerg Care 1994;10:241–3.