Hemoptysis in children: the hospital for sick children experience.

Causes of hemoptysis in children have not been well documented in the paediatric otolaryngology literature. The aim of this retrospective review is to determine the commonest causes of hemoptysis in the paediatric age group presenting to an otolaryngologist. We reviewed the charts of patients presenting to an otolaryngologist at The Hospital for Sick Children, Toronto, Ontario, over a 10-year period. A total of 37 inpatients beyond the neonatal period were referred for further assessment of hemoptysis. Thirty-two patients (86.5%) underwent bronchoscopy to determine the cause, the hemoptysis resolving spontaneously in the remaining five patients without a diagnosis. Four patients who had a bronchoscopy also had no identifiable pathology. Tracheobronchitis was the commonest diagnosis (19%), followed by tracheotomy-related problems (15.5%) Other causes included bronchiectasis, aspiration of blood, pulmonary hemorrhage, foreign-body aspiration, cystic fibrosis, A-V malformation, tracheobronchial hemangioma, hereditary telangiectasia, laceration of a vocal cord, and pneumonia. Otolaryngologists need to be aware of the etiology of hemoptysis in children. The commonest causes are infection and trauma, and not vascular anomalies or neoplasms as often perceived.