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2.
Surg Laparosc Endosc Percutan Tech ; 32(2): 266-271, 2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34545034

RESUMO

BACKGROUND: Congenital tracheobiliary or bronchobiliary fistulae are rare developmental malformations associated with high morbidity and mortality primarily because of concomitant anomalies as well as delays in diagnosis. TECHNICAL REPORT: We report a case of a neonate who presented with bilious emesis and progressive respiratory failure requiring bronchoscopy and fluoroscopic bronchography for diagnosis with successful management through video-assisted thoracoscopic surgery. We also review the published literature on tracheobiliary fistula. CONCLUSION: Use of video-assisted thoracoscopic surgery for fistula resection has been reported in only one other neonate and provides a clinically less invasive option compared with open surgical ligation and resection. To our knowledge, this is the first English language report of thoracoscopic resection in a neonate with congenital tracheobiliary fistula.


Assuntos
Fístula Biliar , Fístula Brônquica , Doenças da Traqueia , Fístula Biliar/diagnóstico por imagem , Fístula Biliar/etiologia , Fístula Biliar/cirurgia , Fístula Brônquica/diagnóstico por imagem , Fístula Brônquica/etiologia , Fístula Brônquica/cirurgia , Humanos , Recém-Nascido , Cirurgia Torácica Vídeoassistida , Doenças da Traqueia/congênito , Doenças da Traqueia/cirurgia
3.
Cardiol Young ; 29(3): 445-447, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30698130

RESUMO

Congenital complete tracheal rings are usually associated with pulmonary slings. We report a rare association of congenital complete tracheal rings with hypoplastic left heart variant. A term infant with diagnosis of a mildly hypoplastic mitral valve, unicuspid aortic valve, and moderately hypoplastic aortic arch with severe coarctation underwent a hybrid procedure initially. Upon failing extubation attempts, complete tracheal rings were seen on direct laryngoscopy. The combination of the lesions resulted in a poor outcome. In patients with failure of extubation post-cardiac surgery, a diagnosis of complete tracheal rings should be included in the differential and a direct laryngoscopy should be considered.


Assuntos
Anormalidades Múltiplas , Síndrome do Coração Esquerdo Hipoplásico/diagnóstico , Traqueia/anormalidades , Doenças da Traqueia/congênito , Broncoscopia , Procedimentos Cirúrgicos Cardíacos/métodos , Ecocardiografia , Evolução Fatal , Feminino , Humanos , Síndrome do Coração Esquerdo Hipoplásico/cirurgia , Imageamento Tridimensional , Recém-Nascido , Laringoscopia , Doenças Raras , Tomografia Computadorizada por Raios X , Doenças da Traqueia/diagnóstico
4.
AJR Am J Roentgenol ; 212(1): 215-221, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30422714

RESUMO

OBJECTIVE: The purpose of this study is to determine which MRI parameters of fetal head and neck masses predict high-morbidity neonatal outcomes, including ex utero intrapartum treatment (EXIT) procedure. MATERIALS AND METHODS: This retrospective study (2004-2016) included parameters of polyhydramnios (based on largest vertical pocket), mass effect on the trachea, mass midline extension, and morphologic grade and size of masses. The morbid cohort included those requiring an EXIT procedure, difficult intubation at delivery, or lethal outcome. Predictive modeling with a multivariable logistic regression and ROC analysis was then performed. RESULTS: Of 36 fetuses, five were delivered by EXIT procedures, there was one neonatal death within 12 hours after delivery, and another neonate required multiple intubation attempts. The remaining 29 fetuses were delivered at outside institutions with no interventions or neonatal morbidity. The largest vertical pocket and mass effect on the trachea were selected as independent predictors by the logistic regression. The cross-validated ROC AUC was 0.951 (95% CI, 0.8795-1). CONCLUSION: The largest vertical pocket measurement and mass effect on the trachea were the most contributory MRI parameters that predicted significant morbidity in fetuses with masses of the face and neck, along with other significant parameters. These parameters predict significant morbid neonatal outcomes, including the need for EXIT procedures.


Assuntos
Doenças Fetais/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/congênito , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Diagnóstico Pré-Natal/métodos , Adulto , Feminino , Humanos , Poli-Hidrâmnios/diagnóstico por imagem , Gravidez , Resultado da Gravidez , Estudos Retrospectivos , Doenças da Traqueia/congênito , Doenças da Traqueia/diagnóstico por imagem
5.
Indian Pediatr ; 55(11): 995-996, 2018 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-30587651

RESUMO

BACKGROUND: Congenital tracheobiliary fistula is a rare developmental anomaly with a persistent communication between the biliary system and the trachea. CHARACTERISTICS: A 7-day-old baby with severe respiratory distress and aspiration pneumonia. OUTCOME: Tracheobilliary fistula identified on bronchoscopy. Open surgical excision of fistula was followed by improvement. MESSAGE: This condition should be considered in the differential diagnosis of intractable aspiration pneumonia.


Assuntos
Fístula Biliar/diagnóstico , Doenças da Traqueia/diagnóstico , Fístula Biliar/complicações , Fístula Biliar/congênito , Broncoscopia/métodos , Diagnóstico Diferencial , Humanos , Recém-Nascido , Masculino , Pneumonia Aspirativa/etiologia , Tomografia Computadorizada por Raios X , Traqueia/anormalidades , Doenças da Traqueia/complicações , Doenças da Traqueia/congênito
6.
Pediatr Surg Int ; 34(7): 701-713, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29846792

RESUMO

Congenital malformations of the trachea include a variety of conditions that cause respiratory distress in neonates and infants. A number of anomalies are self-limiting while others are life-threatening and require immediate therapy. The prevalence of congenital airway malformations has been estimated to range between 0.2 and 1 in 10,000 live births. The most frequent congenital tracheal malformations are: tracheomalacia, congenital tracheal stenosis, laryngotracheal cleft and tracheal agenesis. The management of congenital tracheal malformations is complex and requires an individualized approach delivered by a multidiscipilinary team within centralized units with the necessary expertise.


Assuntos
Traqueia/anormalidades , Estenose Traqueal/congênito , Traqueomalácia/congênito , Constrição Patológica , Anormalidades do Sistema Digestório , Esôfago/anormalidades , Humanos , Laringe/anormalidades , Anormalidades do Sistema Respiratório , Doenças da Traqueia/congênito
7.
Interact Cardiovasc Thorac Surg ; 26(4): 660-666, 2018 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-29244167

RESUMO

OBJECTIVES: Despite the fact that team management has improved the results in recent years, perioperative deaths and complications remain high in paediatric tracheal surgery. We reviewed our institutional experience by comparing our results with those in the literature. METHODS: Between 2005 and 2017, 30 children underwent surgery for tracheal disease. Fifteen were boys and fifteen were girls (50% vs 50%). The median age at operation was 7 months (15 days-9.6 years), and the median weight was 5.2 kg (2.8-34 kg). Congenital tracheal stenosis was diagnosed in 25 children (83.3%), and 5 (16.7%) had acquired lesions. The mean internal diameter in congenital tracheal stenosis was 1.5 mm, with complete tracheal rings present in all patients. Associated malformations were bronchopulmonary in 11 cases (36.7%) and cardiovascular in 16 (53.3%). RESULTS: No in-hospital deaths occurred in our data set. Overall mortality was 4 of 30 cases (13.3%). Twenty-four endoscopic reinterventions were required in 19 children (63%) and consisted of stent positioning in 13 (43.3%), balloon dilatation in 5 (16.7%), granulation removal in 4 (13.3%) and tracheostomy in 2 (6.7%). Of the survivors (26 of 30, 86.7%), 11 children (42.3%) did not require further examination on adequate tracheal diameter for age and absence of symptoms after a median follow-up period of 3.5 years. CONCLUSIONS: The result of paediatric tracheal surgery depends on several factors. The number of cases treated at a particular centre is an important one, but our experience, although limited, can be compared with that at centres with a higher volume of cases. We emphasize the need for applying a multidisciplinary approach to master the surgical command of different reconstructive tracheal procedures, to manage associated defects, particularly cardiovascular defects, and to manage complications under endoscopic guidance. These can be considered the mainstays of building a successful tracheal programme.


Assuntos
Previsões , Procedimentos de Cirurgia Plástica/métodos , Traqueia/cirurgia , Doenças da Traqueia/cirurgia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Inquéritos e Questionários , Doenças da Traqueia/congênito , Doenças da Traqueia/diagnóstico , Resultado do Tratamento
8.
J Craniofac Surg ; 28(3): 696-699, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28468151

RESUMO

Tracheal cartilaginous sleeve (TCS) is a rare and previously unrecognized source of morbidity and mortality in patients with certain craniosynostosis syndromes. There is a paucity of reporting on this airway anomaly, and the true incidence of TCS is largely unknown. The purpose of this study was to investigate the incidence of TCS among patients with syndromic craniosynostosis at our institution. Patients with syndromic craniosynostosis who underwent direct bronchoscopy and laryngoscopy were evaluated retrospectively by pediatric otolaryngologists for the presence of TCS and associated anomalies. Among patients with a diagnosis of syndromic craniosynostosis in our craniofacial database, 10 (37%) were found to have previous direct bronchoscopy and laryngoscopy reports. Of these 10 patients, 2 had Crouzon syndrome, 3 had Pfeiffer syndrome, 3 had Apert syndrome, 1 had Muenke syndrome, and 1 had Antley-Bixler syndrome. Eighty percent (8/10) of these patients were found to have some evidence of TCS. The most commonly observed associated findings included the following: tracheostomy dependency (7/10; 70%), hearing loss (6/10; 60%), obstructive sleep apnea (5/10; 50%), cervical spine anomalies (5/10; 50%), developmental delay (5/10; 50%), and enlarged cerebral ventricles (4/10; 40%). Larger multicenter studies are required to further characterize this airway anomaly and its impact on this patient population. Our results confirm the importance of thorough airway evaluation at initial presentation and the need for validated screening protocols.


Assuntos
Anormalidades Múltiplas , Cartilagem/anormalidades , Craniossinostoses/diagnóstico , Apneia Obstrutiva do Sono/epidemiologia , Traqueia/anormalidades , Doenças da Traqueia/congênito , Cartilagem/cirurgia , Criança , Pré-Escolar , Craniossinostoses/epidemiologia , Craniossinostoses/cirurgia , Feminino , Humanos , Masculino , Morbidade/tendências , Estudos Retrospectivos , Apneia Obstrutiva do Sono/etiologia , Apneia Obstrutiva do Sono/cirurgia , Taxa de Sobrevida/tendências , Traqueia/cirurgia , Doenças da Traqueia/diagnóstico , Doenças da Traqueia/epidemiologia , Traqueostomia/métodos , Estados Unidos/epidemiologia
9.
Semin Pediatr Surg ; 25(3): 186-90, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27301606

RESUMO

Regenerative medicine offers hope of a sustainable solution for severe airway disease by the creation of functional, immunocompatible organ replacements. When considering fetuses and newborns, there is a specific spectrum of airway pathologies that could benefit from cell therapy and tissue engineering applications. While hypoplastic lungs associated with congenital diaphragmatic hernia (CDH) could benefit from cellular based treatments aimed at ameliorating lung function, patients with upper airway obstruction could take advantage from a de novo tissue engineering approach. Moreover, the international acceptance of the EXIT procedure as a means of securing the precarious neonatal airway, together with the advent of fetal surgery as a method of heading off postnatal co-morbidities, offers the revolutionary possibility of extending the clinical indication for tissue-engineered airway transplantation to infants affected by diverse severe congenital laryngotracheal malformations. This article outlines the necessary basic components for regenerative medicine solutions in this potential clinical niche.


Assuntos
Doenças da Laringe/congênito , Doenças da Laringe/cirurgia , Anormalidades do Sistema Respiratório/cirurgia , Engenharia Tecidual/métodos , Doenças da Traqueia/congênito , Doenças da Traqueia/cirurgia , Terapias Fetais/métodos , Regeneração Tecidual Guiada , Humanos , Recém-Nascido , Laringe/anormalidades , Laringe/cirurgia , Transplante de Tecidos , Traqueia/anormalidades , Traqueia/cirurgia
10.
J Wildl Dis ; 52(2): 411-3, 2016 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-27054473

RESUMO

We describe a congenital tracheal web malformation in a wild female brown bear (Ursus arctos) yearling that was euthanized after being hit by a train in Norrbotten County, Sweden, December 2010. A 3-cm-long, abnormal, longitudinal mucosal fold divided the trachea into two halves, without obviously blocking the airflow.


Assuntos
Doenças da Traqueia/veterinária , Ursidae/anormalidades , Animais , Suécia , Doenças da Traqueia/congênito , Doenças da Traqueia/patologia
11.
Ann Thorac Surg ; 99(1): 328-31, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25555959

RESUMO

Congenital tracheobiliary fistula is a rare malformation that allows communication between the respiratory system and hepatobiliary tract. We describe a male adolescent patient who was admitted with a destroyed lung caused by repetitive bile pneumonitis with a congenital tracheobiliary fistula. Left pneumonectomy was performed, and the fistula tract was successfully divided.


Assuntos
Fístula Biliar/congênito , Fístula do Sistema Respiratório/congênito , Doenças da Traqueia/congênito , Adolescente , Humanos , Masculino
13.
Recenti Prog Med ; 104(7-8): 442-5, 2013.
Artigo em Italiano | MEDLINE | ID: mdl-24042425

RESUMO

Congenital malformations are an heterogeneous group of disorders that can lead changes in pulmonary perfusion and then can be evaluated with lung perfusion scintigraphy. We selected five patients in which the role of lung perfusion scintigraphy emerges as a reliable and non-invasive imaging technique. Lung perfusion scintigraphy is a useful tool in pediatric patients with congenital malformations allowing an accurate evaluation of the best therapeutic strategy and its results.


Assuntos
Dextrocardia/diagnóstico por imagem , Cardiopatias Congênitas/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Imagem de Perfusão/métodos , Artéria Pulmonar/anormalidades , Atelectasia Pulmonar/diagnóstico por imagem , Circulação Pulmonar , Veias Pulmonares/anormalidades , Veias Pulmonares/diagnóstico por imagem , Anormalidades Múltiplas , Adolescente , Fístula Brônquica/congênito , Criança , Pré-Escolar , Dextrocardia/cirurgia , Atresia Esofágica , Cardiopatias Congênitas/cirurgia , Hérnia Diafragmática/cirurgia , Hérnias Diafragmáticas Congênitas , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/cirurgia , Masculino , Complicações Pós-Operatórias/diagnóstico por imagem , Atelectasia Pulmonar/etiologia , Veias Pulmonares/cirurgia , Fístula do Sistema Respiratório/congênito , Doenças da Traqueia/congênito , Veia Cava Inferior/anormalidades
17.
Am J Obstet Gynecol ; 205(6): 544.e1-8, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21944224

RESUMO

OBJECTIVE: We sought to develop a gestational age-independent sonographic parameter to characterize lung growth. STUDY DESIGN: Reported descriptors of lung growth, including lung-to-head circumference (HC) ratio (LHR) and observed/expected LHR, were examined. A new index, the quantitative lung index (QLI) was derived using published data on HC and the area of the base of the right lung. RESULTS: Neither the LHR nor the observed/expected LHR proved to be gestational age independent. Right lung growth can be expressed using the following formula: QLI = lung area/(HC/10)^2. The 50th percentile of the QLI remained constant at approximately 1.0 for the gestational age between 16-32 weeks. A small lung (<1st percentile) was defined as a QLI <0.6. CONCLUSION: Fetal right lung growth can be adequately described using the QLI, independent of gestational age. Further studies are needed to assess the clinical accuracy of the QLI in characterizing fetal right lung growth.


Assuntos
Pulmão/diagnóstico por imagem , Pulmão/embriologia , Modelos Biológicos , Ultrassonografia Pré-Natal/métodos , Ultrassonografia Pré-Natal/estatística & dados numéricos , Tamanho Corporal , Feminino , Desenvolvimento Fetal , Idade Gestacional , Cabeça/diagnóstico por imagem , Cabeça/embriologia , Hérnia Diafragmática/diagnóstico por imagem , Hérnias Diafragmáticas Congênitas , Humanos , Tamanho do Órgão , Valor Preditivo dos Testes , Gravidez , Traqueia/diagnóstico por imagem , Traqueia/embriologia , Doenças da Traqueia/congênito , Doenças da Traqueia/diagnóstico por imagem
20.
J Pediatr Surg ; 45(4): E9-11, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20385268

RESUMO

Congenital tracheobiliary fistula is a rare malformation that can present with a variety of respiratory symptoms. We present a case of a newborn patient with a tracheobiliary fistula and severe respiratory insufficiency needing extracorporal membrane oxygenation to recover.


Assuntos
Fístula Biliar/terapia , Oxigenação por Membrana Extracorpórea , Insuficiência Respiratória/terapia , Fístula do Sistema Respiratório/terapia , Doenças da Traqueia/terapia , Fístula Biliar/congênito , Fístula Biliar/cirurgia , Feminino , Humanos , Recém-Nascido , Insuficiência Respiratória/etiologia , Fístula do Sistema Respiratório/congênito , Fístula do Sistema Respiratório/cirurgia , Doenças da Traqueia/congênito , Doenças da Traqueia/cirurgia
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