Abstract：
Hemoptysis in the pediatric population, while infrequent, poses significant challenges for both the family and healthcare practitioners. The severity of hemoptysis dictates management decisions. Most cases being mild and self-limiting are treated conservatively. However, \"life-threatening hemoptysis\" may occur, and is defined as any degree of blood loss that endangers the airway and is arbitrarily considered to be > 8 ml/kg in 24 h in children. It requires prompt airway management and resuscitation followed by a tailored approach consisting of bronchoscopy, computed tomography (CT), interventional radiology, and/or surgery depending on the patient \'s clinical status and cardiopulmonary comorbidities. Bronchial arteries are hypertrophied in myriad conditions and account for 90-95% cases of hemoptysis due to their systemic pressure levels; the rest being contributed by pulmonary artery pathologies. Despite similar pathogenic mechanisms, the etiologies of pediatric hemoptysis differ from those in adults, with acute lower respiratory tract infections being the predominant cause. Imaging plays a crucial role in identifying the source and cause of hemorrhage. Multidetector computed tomography (MDCT) has emerged as a prime modality in the diagnostic evaluation of hemoptysis and provides a roadmap for potential interventional procedures. This article discusses the etiopathogenesis of hemoptysis along with a brief mention of the diagnostic modalities. It provides a structured reporting format and uses it to illustrate the imaging features in hemoptysis, with emphasis on CT angiography. The key findings in the lung parenchyma, airways, bronchial and non-bronchial systemic collaterals, and pulmonary arteries are elaborated upon. It further addresses the nuances of interventional management, particularly emphasizing the applications of bronchial artery embolization and pulmonary artery embolization in the pediatric population. The article also underscores the potential complications and factors influencing recurrence rates.
摘要：
儿科人群咯血，虽然不常见，对家庭和医疗保健从业人员提出了重大挑战。咯血的严重程度决定了管理决策。大多数轻度和自限性的病例都是保守治疗。然而,可能发生“危及生命的咯血”，并且被定义为危及气道的任何程度的失血，并且在儿童中被任意认为在24小时内>8ml/kg。它需要及时的气道管理和复苏，然后是由支气管镜检查组成的量身定制的方法，计算机断层扫描（CT），介入放射学,和/或手术取决于患者的临床状态和心肺合并症。支气管动脉在各种情况下都肥大，由于其全身压力水平，咯血占90-95％；其余的由肺动脉病变造成。尽管致病机制相似，小儿咯血的病因与成人不同，急性下呼吸道感染是主要原因。影像学在确定出血的来源和原因中起着至关重要的作用。多探测器计算机断层扫描（MDCT）已成为咯血诊断评估的主要方式，并为潜在的介入程序提供了路线图。本文讨论了咯血的病因，并简要提及了诊断方式。它提供了一个结构化的报告格式，并用它来说明咯血的影像学特征，重点是CT血管造影。肺实质的关键发现,气道,支气管和非支气管全身络脉，并详细阐述了肺动脉。它进一步解决了介入管理的细微差别，特别强调支气管动脉栓塞术和肺动脉栓塞术在儿科人群中的应用。文章还强调了潜在的并发症和影响复发率的因素。
