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Category: BRONCHOSCOPY IN DISEASES OF THE TRACHEA AND BRONCHI
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
This is chiefly observed in children.
The most frequently encountered form is the epidemic disease to which
the name Influenza has been given (q.v. supra). The only noticeable
difference between the epidemic and the sporadic cases is in the more
general susceptibility to the infective agent, which gives the
influenzal form an appearance of being more virulently infective.
Possibly the sporadic form is simply the attack of children not
immunized by a previous attack during an epidemic.
There is another form of edematous tracheobronchitis often of great
severity and grave prognosis, that results from the aspiration of
irritating liquids or vapors, or of certain organic substances such as
peanut kernels, watermelon seeds, etcetera. Tracheotomy should be done
if marked dyspnea be present. Secretions can then be easily removed
and medication in the form of oily solutions be instilled at will into
the trachea. In the Bronchoscopic Clinic many children have been kept
alive for days, and their lives finally saved by aspiration of thick,
tough, sometimes clotted and crusted secretions, with the aspirating
tube (Fig. 10). It is better in these cases not to pass the
bronchoscope repeatedly. If, however, evidences of obstruction remain,
after aspiration, it is necessary to see the nature of the obstruction
and relieve it by removal, dilatation, or bronchial intubation as the
case may require. It is all a matter of plumbing i.e., clearing out
the pipes, and maintaining a patulous airway.
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