Hemoptysis or Coughing up blood is a frightening condition for children and parents. Bleeding sometimes can be minor but occasionally can be massive needing emergency treatment. As children tend to swallow their phlegm our sputum hence hemoptysis might go unnoticed for a long time unless bleeding is substantial.
What are the common causes of hemoptysis in children?
The causes of hemoptysis or Coughing up blood can be many. Most common causes in children in India are related to infections like pneumonia and tuberculosis or TB. Other causes of hemoptysis or Coughing up blood could be bronchiectasis and cystic fibrosis. Some children with foreign bodies in the lungs can also present with hemoptysis or Coughing up blood. Lesions in the airways of the lungs like hemangioms, hemartoma, carcinoids and cancers are also a rare cause of hemoptysis or Coughing up blood. In some children the small blood vessels inside the lungs start bleeding, a condition called pulmonary hemosiderosis.
Occasionally children might be bleeding from the nose and aspirating blood or might be bleeding from the gastrointestinal tract which might be appearing like Hemoptysis or Coughing up blood. This must be carefully evaluated in detail.
How do we diagnose the cause of hemoptysis?
The case history and detailed physical examination of the child is the starting point. A Chest Xray is a very useful screening test for children with hemoptysis. Some children with hemoptysis or coughing up blood might require further investigations to ascertain the cause of the bleeding. These investigations include a CT SCAN of the chest with contrast, CT Chest angiography and flexible diagnostic bronchoscopy. CT angiography of the chest helps in evaluation of the blood vessels inside the lungs in detail. A diagnostic flexible bronchoscopy is a useful test for checking the nose, nasophayrnx, larynx or voice box, trachea or windpipe and bronchi from inside. A diagnostic flexible bronchoscopy helps to locate the site of bleeding and also to point out the precise cause.
What is the treatment of hemoptysis in children?
The treatment of hemoptysis or coughing up blood in children is based on the underlying cause or the disease. Some medicines can be used for a short time to reduce or stop bleeding like tranexamic acid or ethamsylate.
If your child has got blood in a cough or hemoptysis you need to contact a pediatric chest specialist urgently for further advice.