1/97. A bronchogenic cyst in an infant causing tracheal occlusion and cardiac arrest.A 3-month-old infant treated for 3 weeks for suspected bronchiolitis, developed episodes of profound desaturation. A lateral X-ray showed displacement and compression of the trachea. Respiratory arrest, from which she was successfully resuscitated, occurred just before MRI scan. The mass was removed at thoracotomy and a histological diagnosis of a bronchogenic cyst was made. Mediastinal masses in babies are relatively rare, and the situation in which they present with acute respiratory distress may prove extremely challenging to the anaesthetist. Bronchogenic cysts are difficult to diagnose pre-operatively and awareness may assist in the peri-operative management of these infants.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
2/97. Stridor in a 6-week-old infant caused by right aortic arch with aberrant left subclavian artery.BACKGROUND: Persistent infant stridor, seal-like cough, and difficulty feeding can be the initial signs of right aortic arch with an aberrant left subclavian artery. This congenital cardiovascular abnormality results in the development of a vascular ring that encircles the trachea and esophagus. methods: A case report is presented that describes the evaluation and care of a 6-week-old male infant whose condition was diagnosed as right aortic arch and aberrant left subclavian artery after he was brought to the family practice clinic with a history of persistent stridor. This case report involved a patient seen in the author's outpatient clinic during a well-child check. Data were obtained from the patient's medical record and review of his radiologic diagnostic tests. medline and Index Medicus literature searches were conducted for the years 1966 to the present, using the key words "stridor" and "vascular ring," with cross-references for earlier articles. RESULTS AND CONCLUSIONS: Persistent or recurrent stridor associated with feeding difficulties should prompt an investigation for a vascular ring. In general, an anteroposterior and lateral neck radiograph and a posteroanterior and lateral chest radiograph are usually the initial diagnostic tests to evaluate stridor. Persistent stridor and new-onset regurgitation of formula in a 6-week-old infant prompted an escalation of the patient's workup to include a barium swallow, which subsequently showed compression of the esophagus caused by a vascular ring. In some cases direct observation with a laryngoscope or bronchoscope might be necessary to determine the cause of stridor. Indications for hospitalization of patients with stridor include stridor at rest, dyspnea, actual or suspected epiglottis, repeatedly awakening from sleep with stridor, a history of rapid progression of symptoms, toxic appearance, and apneic or cyanotic episodes. The primary care provider should be familiar with the evaluation and management for patients with the complaint of persistent or recurrent stridor.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
3/97. Respiratory distress due to tracheal compression by the dilated innominate artery.The case reported is of an 88 yr old female with hypertension and respiratory distress. A chest radiograph revealed a widening of the upper mediastinum. Computed tomographic scanning revealed tracheal compression by the innominate artery, which was elongated and curved. After intubation, she was treated with antihypertensive drugs. This resulted in the remarkable recovery of the patient from respiratory distress. To the authors' knowledge, this is the first reported case of respiratory distress owing to tracheal compression by elongation and curvature of the innominate artery.- - - - - - - - - - ranking = 6keywords = compression (Clic here for more details about this article) |
4/97. airway management and transesophageal echocardiographic monitoring for pulmonary artery sling.pulmonary artery sling is an uncommon vascular anomaly and can be life threatening when it causes tracheal compression. We report on a 14-day-old boy who presented with respiratory distress soon after birth. A series of examinations showed tracheal stenosis due to a pulmonary artery sling. Surgery was performed with the aid of cardiopulmonary bypass. The external compression and intrisic stenosis could not be resolved by vascular surgery because of tracheal malacia and a complete tracheal ring. We recommend cutting extra holes 1 to 2 cm from the distal end of the endotracheal tube for endobronchial intubation. The airway obstruction was resolved successfully with a custom-made endobronchial tube. However, the patient died of pneumomediastinum and pneumothorax induced by barotrauma, on the fourth postoperative day.- - - - - - - - - - ranking = 2keywords = compression (Clic here for more details about this article) |
5/97. Treatment of giant aortic aneurysm with tracheal compression and sternal erosion without circulatory arrest.Treatment of huge aneurysms involving the ascending aorta and the aortic arch with compression of the surrounding structures represents a surgical challenge. The case of a patient affected by respiratory insufficiency and sternal erosion caused by chronic giant aortic aneurysm is reported. The use of a stepwise approach and selective cerebral arterial perfusion ensured successful operative management, avoiding circulatory arrest and enabling an expeditious postoperative recovery.- - - - - - - - - - ranking = 5keywords = compression (Clic here for more details about this article) |
6/97. Double aortic arch: diagnosis missed for 29 years.Double aortic arch is a rare vascular anomaly which causes tracheal and esophageal compression usually in the first months of life. Typical symptoms in the early childhood should lead to prompt diagnosis and surgical treatment of this malformation. In adults this anomaly is extremely rare. A case of a severely 29-year-old symptomatic woman is presented. Despite characteristic symptoms, the diagnosis was missed during childhood. The importance of different diagnostic procedures and operative therapy is discussed. Preoperative angiography can be replaced by the less invasive magnetic imaging and computed tomography. Surgical operation should also be performed in oligosymptomatic patients to prevent late complications.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
7/97. Uncommon complication of arterial switch operation: tracheobronchial compression.We describe 2 patients in whom symptoms of airway compression developed after arterial switch operation for correction of the transposition of the great arteries. The clinical features, diagnosis, management, and proposed mechanisms of this complication are described.- - - - - - - - - - ranking = 5keywords = compression (Clic here for more details about this article) |
8/97. diagnosis of anomalous innominate artery syndrome by spiral CT with 3D reconstruction of the airway: report of one case.Stridor in infants is a symptom that indicates partial obstruction of the large airways. Vascular rings are an unusual cause of tracheal compression which can induce stridor in infants and children. We report a 4-month-old boy with recurrent wheezing and stridor for 2 months. Spiral computed tomography (CT) and three-dimensional (3D) reconstruction aided in the diagnosis of external compression on the trachea by an innominate artery. Successful relief of the airway's obstruction was achieved by aortopexy. Three months after surgery, he was symptom free without any medication.- - - - - - - - - - ranking = 2keywords = compression (Clic here for more details about this article) |
9/97. Mechanical tracheal obstruction due to an intramural esophageal hematoma following endoscopic variceal sclerotherapy.Endoscopic injection sclerotherapy is widely used as treatment for bleeding esophageal varices. Esophageal intramural hematoma is a rare complication following endoscopic injection sclerotherapy. patients present with pain and dysphagia due to esophageal obstruction. We present the first reported case of respiratory failure resulting from an intramural hematoma causing posterior tracheobronchial compression. Although patients with alcoholic cirrhosis and bleeding varices requiring respiratory support generally have a poor prognosis this may be an occasion when ventilatory support may be expected to be easily withdrawn after hematoma resolution.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
10/97. Dental bar tracheopexy in a neonate.Double aortic arch often presents with tracheoesophageal compression. Management requires division of the vascular ring and, if tracheomalacia is present, some form of tracheopexy. We report here the use of a dental bar as an external splint for tracheopexy in a neonate. Follow-up to 18 months shows good tracheal growth and no erosion.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
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