Plastic bronchitis (PB) is a rare condition characterized by the formation and expectoration of cohesive endobronchial casts that mimic the shape of local airways. It is often associated with cardiothoracic surgeries and various respiratory diseases, but pediatric cases without congenital heart disease remain poorly understood. This case series reports ten pediatric patients with non-cardiac PB, successfully managed through flexible bronchoscopy. The cohort included children aged 2-12 years, with a gender distribution of 50% boys and 50% girls. Underlying conditions included asthma, allergic histories, and primary ciliary dyskinesia. Infectious causes, including Influenza A and adenovirus, were identified in three cases. Bronchial casts were extracted with flexible bronchoscopy, using a suction channel, and one patient required a repeat bronchoscopy after the installation of dornase alfa for adherent casts. Histopathological examination revealed eosinophilic casts in the majority of patients. Treatment involved inhaled corticosteroids, with some patients receiving systemic steroids. No recurrences of PB were observed during follow-up, and all patients showed resolution of symptoms. This case series highlights the successful management of non-cardiac PB in children, emphasizing the role of bronchoscopy and tailored therapies. Further research is needed to explore optimal treatment strategies and the underlying pathophysiology of PB.
