Pulmonary artery sling anomaly presenting with unilateral lung hyperinflation: A case report

Left pulmonary artery sling is a rare congenital pulmonary artery anomaly whichpresents with tracheal compression due to vascular ring formation. Rarely,patients may present with hyperinflation or collapse of a lung unilaterally.We present a one-month-old infant with dyspnea who had a hyperinflatedleft lung and collapsed right lung. Computed tomography (CT) angiographydemonstrated pulmonary sling causing compression of proximal parts of rightand left main bronchi. This case highlights the importance of three-dimensionalCT angiography in evaluation of thoracic vascular anomalies associated withtracheobronchial pathologies.

PDF

___

1. Lee KH, Yoon CS, Choe KO, et al. Use of imaging for assessing anatomical relationships of tracheobronchial anomalies associated with left pulmonary artery sling. Pediatr Radiol 2001; 31: 269-278.

2. Berdon WE, Baker DH, Wung JT, et al. Complete cartilage-ring tracheal stenosis associated with anomalous left pulmonary artery: the ring-sling complex. Radiology 1984; 152: 57-64.

3. Backer CL, Mongé MC, Popescu AR, Eltayeb OM, Rastatter JC, Rigsby CK. Vascular rings. Semin Pediatr Surg 2016; 25: 165-175.

4. Zhong YM, Jaffe RB, Zhu M, Gao W, Sun AM, Wang Q. CT assessment of tracheobronchial anomaly in left pulmonary artery sling. Pediatr Radiol 2010; 40: 1755-1762.

5. Wells TR, Gwinn JL, Landing BH, Stanley P. Reconsideration of the anatomy of sling left pulmonary artery: The association of one form with bridging bronchus and imperforate anus. Anatomic and diagnostic aspects. J Pediatr Surg 1988; 23: 892-898.

6. Berdon WE, Muensterer OJ, Zong YM, Backer CL. The triad of bridging bronchus malformation associated with left pulmonary artery sling and narrowing of the airway: The legacy of Wells and Landing. Pediatr Radiol 2012; 42: 215-219.

7. Hu XH, Pa ME, Shen QL, Huang GY. Multi-detector computed tomography evaluation of tracheobronchial anomaly in pediatric patients with left pulmonary artery sling. Chin Med J (Engl) 2013;126: 2790-2792.

8. Chao YC, Peng CC, Lee KS, Lin SM, Chen MR. The association of congenital tracheobronchial stenosis and cardiovascular anomalies. Int J Pediatr Otorhinolaryngol 2016; 83: 1-6.

9. Dillman JR, Sanchez R, Ladino-Torres MF, Yarram SG, Strouse PJ, Lucaya J. Expanding upon the unilateral hyperlucent hemithorax in children. Radiographics 2011; 31: 723-741.

10. Leonardi B, Secinaro A, Cutrera R, et al. Imaging modalities in children with vascular ring and pulmonary sling. Pediatr Pulmonol 2015; 50: 781-788.