Çocuklarda tekrarlayan hışıltının bir nedeni olarak pulmoner arter sling
Vasküler ringler, bir grup aortik ark anomalisi olup genellikle doğumdan sonra solunum zorluğu, stridor ve beslenme güçlükleriyle ortaya çıkar. Pulmoner arter sling, sol pulmoner arterin sağ pulmoner arter arka cephesinden anormal köken almasıyla oluşturulur. Bu anormal sol pulmoner arter, alt trakea ve sağ ana bronşa bası yaparak üst hava yolu semptomlarına neden olur. Burada tekrarlayan hışıltı, stridor ve tekrarlayan alt solunum yolu infeksiyonu nedeniyle kliniğimize başvuran yedi aylık erkek hasta sunuldu.
Pulmonary artery sling as a cause of recurrent wheezing in children
Vascular rings are a group of aortic arch anomalies and usually presents with dispnea, stridor and feeding difficulties after birth. Pulmonary artery sling is created by anomalous origin of the left pulmonary artery from the posterior aspect of the right pulmonary artery. The anomalous left pulmonary artery compresses the lower trachea and right mainstem bronchus, producing upper airway symptoms. We presented a seven-month-old male patient who admitted to our clinic because of recurrent wheezing, stridor, and frequent lower respiratory tract infections.
___
- 1. Turner A, Gavel G, Coutts J. Vascular rings-- presentation, investigation and outcome. Eur J Pediatr 2005; 164: 266-70.
- 2. Berrocal T, Madrid C, Novo S, et al. Congenital anomalies of the tracheobronchial tree, lung, and mediastinum: embryology, radiology, and pathology. Radiographics 2004; 24: 17.
- 3. Sebening C, Jakob H, Tochtermann U, et al. Vascular tracheobronchial compression syndromes experience in surgical treatment and literature review. Thorac Cardiovasc Surg 2000; 48: 164-74.
- 4. Fiore AC, Brown JW, Weber TR, Turrentine MW. Surgical treatment of pulmonary artery sling and tracheal stenosis. Ann Thorac Surg 2005; 79: 38-46.
- 5. Hernanz-Schulman M. Vascular rings: a practical approach to imaging diagnosis. Pediatr Radiol 2005; 35: 961-79.
- 6. Takeda Y, Asou T, Fakhri D, et al. Pulmonary artery sling associated with tetralogy of fallot. Asian Cardiovasc Thorac Ann 2005; 13: 77-8.
- 7. Pumberger W, Voitl P, Gopfrich H. Recurrent respiratory tract infections and dysphagia in a child with an aortic vascular ring. South Med J 2002; 95: 265-8.
- 8. Munro HM, Sorbello AM, Nykanen DG. Severe stenosis of a long tracheal segment, with agenesis of the right lung and left pulmonary arterial sling. Cardiol Young 2006; 16: 89-91.
- 9. Kagadis GC, Panagiotopoulou EC, Priftis KN, et al. Preoperative evaluation of the trachea in a child with pulmonary artery sling using 3- dimensional computed tomographic imaging and virtual bronchoscopy. J Pediatr Surg 2007; 42: 9-13.
- 10. Yilmaz M, Ozkan M, Dogan R, et al. Vascular anomalies causing tracheoesophageal compression: a 20-year experience in diagnosis and management. Heart Surg Forum 2003; 6: 149-52.
- 11. Jaffe RB. Magnetic resonance imaging of vascular rings. Semin Ultrasound CT MR 1990; 11: 206-20.
- 12. Backer CL, Mavroudis C. Surgical approach to vascular rings. Adv Card Surg 1997; 9: 29-64.
- 13. Potts W, Holinger P. Anomalous left pulmonary artery causing obstruction to the right main stem bronchus. JAMA 1954; 155: 1409.
- 14. Loukanov T, Sebening C, Springer W. Simultaneous management of congenital tracheal stenosis and cardiac anomalies in infants. J Thorac Cardiovasc Surg 2005; 130: 1537-41.