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3.
Cir. pediátr ; 32(4): 165-171, oct. 2019. ilus, graf, tab
Artigo em Espanhol | IBECS | ID: ibc-184103

RESUMO

Objetivo. Analizar las distintas relaciones anatómicas entre el tronco braquiocefálico (TB), la tráquea, la columna vertebral y el esternón en pacientes diagnosticados de síndrome de compresión de la arteria innominada (SCAI) y compararlas con las de los pacientes controles. Material y métodos. Estudio retrospectivo de casos y controles de los pacientes diagnosticados de SCAI en nuestro centro, a los que se realizó una tomografía computarizada con contraste (TC) y/o resonancia magnética (RM). Se compararon con pacientes controles, elegidos entre enfermos sin malformación cardiaca ni masa torácica deformante, y a los que se les había realizado una TC vascular torácico por distintos problemas respiratorios no obstructivos. Por cada caso, se seleccionaron tres controles, agrupándolos por grupos de edades. Se estableció p<0,05 como valor de significancia estadística. Resultados. Se incluyeron 9 casos (7 niños y 2 niñas) y 27 controles (20 niños y 7 niñas). Se estudió en cortes transversales de la TC la posición horaria del nacimiento del TB respecto a la tráquea, resultando en los casos una posición mediana correspondiente a las 01:30 (00:30- 03:00) y en los controles a las 01:30 (00:30-02:30), sin hallarse diferencias significativas (p= 0,72). Se midió el ratio entre el diámetro anteroposterior/diámetro transverso de la tráquea, este fue de 0,44 (0,184-0,6) en los casos y 0,885 (0,64-1,16) en los controles (p=0,00001). El ratio de la distancia esternón-tráquea/esternón-columna fue 0,685 (0,6-0,76) en los casos y 0,67 (0,49-0,79) en los controles (p=0,75). El ángulo de la cifosis torácica fue 29º (9-34) en los casos y 24º (4-33) en los controles (p=0,45). Conclusiones. No observamos la existencia de diferencias en el nacimiento del TB en pacientes con SCAI respecto a la población general. El TB nace en todos los niños en el lado izquierdo del cuerpo, poniendo en duda que el SCAI sea debido a un nacimiento más izquierdo del TB


Objective. To compare the anatomical relations between brachioce-phalic trunk (BT), trachea, spine and sternum in patients with Innominate Artery Compressing Syndrome (IACS) and control patients. Methods. Retrospective case-control study of patients diagnosed with IACS in our center, in whom vascular computerized tomography (CT) was performed. The CT were compared with those of control patients free of obstructive respiratory pathology, without congenital heart disease and free of deforming thoracic mass, in whom CT was performed due to other reason. Each case was paired with three controls per case, in similar age groups. The significance value was set as p<0,05.Results. Nine cases were included (7 boys and 2 girls) with their 27 respective controls (20 boys and 7 girls). The BT origin position with respect to the trachea, thought as a clock face, was 01:30 (00:30- 03:00) in cases and 01:30 (00:30-02:30) in controls. No differences were observed (p=0.72). The relation between anteroposterior/transversal tracheal diameters was 0.44 (0.184-0.6) in cases, 0.885 (0.64-1.16) in controls. The sternum-trachea/sternum-vertebra relation was 0.685 (0.6-0.76) in cases, 0.67 (0.49-0.79) in controls. No differences were observed (p=0.75). The angle of thoracic kyphosis was 29º (9º-34º) in cases, 24º (4º-33º) in controls. There were no statistically significant differences (p=0.45). Conclusions. We found no differences between the two groups in the BT origin in relation to the trachea. In all cases, the origin was on the left side of the body. Therefore, we question the premise that IACS is due to a more left origin of BT


Assuntos
Humanos , Masculino , Feminino , Criança , Tronco Braquiocefálico/anatomia & histologia , Tronco Braquiocefálico/diagnóstico por imagem , Aorta Torácica/anatomia & histologia , Aorta Torácica/diagnóstico por imagem , Tronco Braquiocefálico/anatomia & histologia , Estudos Retrospectivos , Estudos de Casos e Controles , Estudos Transversais , Traqueia/anatomia & histologia , Traqueia/diagnóstico por imagem , Tronco Braquiocefálico/diagnóstico por imagem , Tronco Braquiocefálico/patologia
6.
Adv Respir Med ; 87(4): 254, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31476016

RESUMO

Foreign-body aspiration is often a serious medical condition demanding timely recognition and prompt action. Flexible and rigid bronchoscopy have become the cornerstone of both the diagnosis and treatment of patients with suspected airway foreign bodies, which are most commonly seen in patients with foreign body aspiration. We describe a case of a 58-year-old man with a huge fishhook in the right main bronchus.


Assuntos
Brônquios/diagnóstico por imagem , Broncoscopia/métodos , Corpos Estranhos/diagnóstico por imagem , Traqueia/diagnóstico por imagem , Brônquios/patologia , Brônquios/cirurgia , Corpos Estranhos/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Traqueia/patologia , Traqueia/cirurgia
8.
Pediatr Surg Int ; 35(10): 1123-1130, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31410561

RESUMO

OBJECTIVES: Whether to perform surgical or conservative treatment for congenital tracheal stenosis (CTS) is controversial. Thus, the computed tomography (CT) criteria for conservative treatment of CTS were investigated. METHODS: From 2005 to 2017, 28 CTS cases were included. The operative cases and preoperative death cases constituted the required intervention group (group I), and the non-operative surviving cases constituted the observation group (group O). The diameter of the tracheal narrowest part (DTNP) on CT was evaluated as a criterion for non-operative follow-up. RESULTS: Chest CT was performed 19 times in 19 group I cases and 18 times in 9 group O cases. The median age of the patients that underwent CT scan examinations was 3.4 months (range 0-25 months) in group I and 22 months (range 0-60 months) in group O. The cut-off values of the non-operative criteria were 40.8% (AUC: 0.82, p < .01) normal for age of the trachea's narrowest part, and 41.6% normal for body weight (AUC: 0.92, p < .01), respectively. CONCLUSIONS: DTNP is 40% and more of the normal diameter appears necessary for non-surgical management. The present study suggests that the criteria for conservative management of CTS are that the DTNP is not less than 40% of the normal tracheal diameter, with a few symptoms.


Assuntos
Tratamento Conservador/métodos , Gerenciamento Clínico , Tomografia Computadorizada Multidetectores/métodos , Traqueia/diagnóstico por imagem , Estenose Traqueal/terapia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Estenose Traqueal/congênito , Estenose Traqueal/diagnóstico , Resultado do Tratamento
9.
BMJ Case Rep ; 12(8)2019 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-31401579

RESUMO

We present the complex and rare case of an inhaled stoma button causing proximal tracheal stenosis in a laryngectomy patient. The patient was unaware he had inhaled his button and presented with increasing shortness of breath and noisy breathing. In this case we discuss the challenging management of the stenotic tracheal segment above the impacted stoma button and the surgical approach to this difficult airway. The distal foreign body was safely removed using rigid bronchoscopy and balloon dilatation. This difficult airway required multidisciplinary input from the ENT, cardiothoracic and anaesthetic teams.


Assuntos
Corpos Estranhos/cirurgia , Laringectomia/efeitos adversos , Laringoestenose/etiologia , Corpos Estranhos/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Traqueia/diagnóstico por imagem , Traqueia/cirurgia
10.
Comput Methods Programs Biomed ; 177: 203-209, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31319949

RESUMO

BACKGROUND AND OBJECTIVE: Sneezing is one of the most critical conditions that can occur in the human upper airway. As some reports confirm the injury to the human upper respiratory airway while sneezing. Therefore, the accurate study of the distribution of pressure and velocity in this case is of great importance. METHODS: In the present study, using a real human upper airway model, the pressure and velocity of the airflow generated in the tract during the sneezing have been investigated. Also, considering the results from a spirometer device as a boundary condition in the simulation process, the calculations have become reliable. RESULTS: According to the results, during sneezing, taking into account that the average outlet flow rate from the mouth is 4.79 L/s, the velocity of outlet airflow from the mouth and nose reaches 5.3 and 8.4 m/s, respectively. These values were 11.5 and 19, respectively, when the desired maximum flow rate was 10.58 L/s. It can be concluded that the increasing of trachea flow rate, leads to higher percentage of the outlet flow rate from the nose . The highest average pressure and velocity have been occurred in the trachea. Among other salient results of this report, increased average static pressure of larynx to approximately 10 kPa can be pointed which indicates that this area is critical so that the thyroid cartilage defect is likely to occur. It is also noteworthy that the increase of speed at nasopharynx is up to 125 m/s so that the cross-section changing in this area leads the fluid acts as a jet flow. Due to the specific geometry of the nasal cavity, some streams similar to poor shocks are formed, these shocks get stronger by increasing of the flow rate. The thyroid cartilage and nasal cavity are exposed to maximum static pressure extremums, respectively. CONCLUSIONS: We introduced a model simulating a normal sneezing for two cases using a healthy 30-year-old male person. We believe that the model should be applied for different persons and an atlas of data could be obtained from different cases. This may help the medical system to have more data about the sneezing process.


Assuntos
Nasofaringe/fisiologia , Respiração , Mecânica Respiratória , Espirro , Traqueia/fisiologia , Adulto , Algoritmos , Simulação por Computador , Humanos , Hidrodinâmica , Imageamento Tridimensional , Masculino , Modelos Anatômicos , Cavidade Nasal/diagnóstico por imagem , Cavidade Nasal/fisiologia , Nasofaringe/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Traqueia/diagnóstico por imagem
11.
Dent Med Probl ; 56(2): 191-196, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31274257

RESUMO

Class II malocclusion may be caused by the maxillary protrusion or the mandibular retrusion. One treatment method is to use a headgear, which might affect the dimensions of the patient's airway. The aim of this study was to assess the effect of a headgear on the airway dimensions in class II malocclusion patients. A digital search and a manual search were conducted for English-language articles published from January 2000 to December 2018 about human clinical trials, including the usage of a cervical headgear in class II malocclusion patients who had measurable changes in the airway and/or jaw size. The synthesis methods of the study consisted of data concerning the study design, the type of treatment device, the patient's age at the start, the sample size, the treatment duration, the type of radiography, and the results of treatment; this data was extracted and compared. The quality of the selected articles was assessed. All of the studies had a high risk of bias, providing low-quality evidence of the effectiveness of the headgear therapy on the airway dimensions. The conclusions of the articles differed from each other and there were different mechanisms of changes in the jaw or airway dimensions. Therefore, further studies are required to find the clearest results showing the effect of a cervical headgear in class II malocclusion.


Assuntos
Aparelhos de Tração Extrabucal , Má Oclusão de Angle Classe II , Traqueia , Cefalometria , Humanos , Má Oclusão de Angle Classe II/terapia , Maxila , Radiografia , Traqueia/anatomia & histologia , Traqueia/diagnóstico por imagem
12.
Br J Radiol ; 92(1102): 20190231, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31271542

RESUMO

Viscero-atrial situs encompasses the laterality, relative position and configuration of the abdominal viscera, the atria of the heart and the tracheobronchial tree. Determining the situs and cardiac position is the first step in the commonly used sequential, segmental approach to the imaging evaluation of congenital heart defects (CHD). Abnormalities of visceroatrial situs and cardiac position are frequently associated with the presence of complex CHDs and accurate assessment of situs abnormalities can help predict the probability and type of the defect. Multidetector CT (MDCT) angiography, with its multiplanar reformatting and volume rendering techniques, offers accurate information about the morphology and three-dimensional relationships of the various cardiac and extra cardiac structures. In this pictorial essay, we present the MDCT imaging findings of the spectrum of abnormalities of visceroatrial situs and cardiac position, using a third generation dual source CT scanner.


Assuntos
Angiografia por Tomografia Computadorizada/métodos , Cardiopatias Congênitas/diagnóstico por imagem , Tomografia Computadorizada Multidetectores , Vísceras/diagnóstico por imagem , Brônquios/anormalidades , Brônquios/diagnóstico por imagem , Coração/embriologia , Átrios do Coração/anormalidades , Átrios do Coração/diagnóstico por imagem , Cardiopatias Congênitas/embriologia , Humanos , Levocardia/diagnóstico por imagem , Fígado/anormalidades , Fígado/diagnóstico por imagem , Estômago/anormalidades , Estômago/diagnóstico por imagem , Traqueia/anormalidades , Traqueia/diagnóstico por imagem , Vísceras/anormalidades
14.
Indian Pediatr ; 56(7): 560-562, 2019 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-31333209

RESUMO

OBJECTIVE: To report our experience of tracheobronchial foreign body removal in children using flexible bronchoscopy as the primary mode. METHODS: Hospital records of tracheobronchial foreign body extractions between January, 2006 and January, 2018 were reviewed. Clinical presentations, radiological findings, location and types of tracheobronchial foreign bodies, types of bronchoscopes, complications and outcome of the procedures were analyzed. RESULTS: 283 extractions in children with median (range) age of 18 (5-168) months were reviewed. Extraction by flexible bronchoscope, using wire baskets or grasping forceps, was successful in 260 cases. No major complications were encountered. Mean (SD) time for the procedure was 31 (6.3) minutes. CONCLUSION: Airway foreign bodies can safely be removed by flexible bronchoscopy with minimal complications. This procedure can be considered the primary mode for removal of airway foreign bodies by a trained and experienced person.


Assuntos
Manuseio das Vias Aéreas/métodos , Brônquios/diagnóstico por imagem , Broncoscopia , Corpos Estranhos , Traqueia/diagnóstico por imagem , Broncoscópios , Broncoscopia/efeitos adversos , Broncoscopia/instrumentação , Broncoscopia/métodos , Broncoscopia/estatística & dados numéricos , Pré-Escolar , Feminino , Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico , Corpos Estranhos/etiologia , Corpos Estranhos/terapia , Humanos , Índia/epidemiologia , Lactente , Masculino , Instrumentos Cirúrgicos
15.
J Forensic Leg Med ; 66: 1-3, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31173945

RESUMO

Non-fatal strangulation is a very common but often underestimated cause of severe injury. In this case, a woman experienced several episodes of manual strangulation in an episode of domestic violence which involved loss of consciousness, confusion and neck pain, particularly over the trachea. CT angiogram of the neck showed a small perforation of the trachea at the level of the thoracic inlet. The prevalence of non-fatal strangulation in the Australian general population is unknown, but a study in Western Australia measured a prevalence of 7.4% of women presenting to a sexual assault service. A systematic review analysing data from 9 countries in North America and Europe, estimated a lifetime prevalence by an intimate partner of between 3.0% and 9.7% of all women (1). US data suggests that of those experiencing intimate partner violence, prevalence ranges from 27 to 68% (2, 3). This article considers the limited science known about the injuries sustained from non-fatal manual strangulation, much of which is extrapolated from case reports in the literature.


Assuntos
Asfixia/etiologia , Violência Doméstica , Lesões do Pescoço/complicações , Traqueia/lesões , Confusão/etiologia , Enfisema/diagnóstico por imagem , Feminino , Humanos , Cervicalgia/etiologia , Tomografia Computadorizada por Raios X , Traqueia/diagnóstico por imagem , Inconsciência/etiologia , Adulto Jovem
16.
J Laparoendosc Adv Surg Tech A ; 29(10): 1228-1231, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31219396

RESUMO

Background: Posterior tracheomalacia is characterized by collapsibility of the posterior trachea and is often present in patients with congenital esophageal atresia (EA) with or without tracheoesophageal fistula (TEF). It can lead to a variety of symptoms from mild expiratory stridor and difficulty clearing secretions to severe respiratory distress, especially in the setting of increased work of breathing. Depending on the severity of symptoms, treatment ranges from medical therapy, including airway clearance techniques, aerosolized medications, and steroids to surgical treatment. The purpose of this study is to review our institution's experience with posterior tracheopexy. Materials and Methods: A retrospective review was conducted from 2017-2019 at a freestanding quaternary care children's hospital. Results: The analysis included 8 patients. The median age at surgery was 6 (range 3-8) years and 4 (50%) of cohort were male. The majority of patients (n = 6, 75%) had a history of prior EA and TEF repair and 3 (38%) had associated VACTERL anomalies. All patients demonstrated severe tracheomalacia on preoperative bronchoscopy with collapse of the posterior membrane. In regard to surgical approach, most cases (6/8, 75%) underwent thoracoscopic repair. The median operative time was 218 (193 thoracoscopic, 218 open) minutes. The median length of stay was 3 days, and 2 (25%) patients had a postoperative complication of chylothorax (1 thoracoscopic and 1 open), both of which resolved without invasive intervention. The current median length of follow-up is 3 months, and all patients reported symptomatic improvement. One patient who had initial symptomatic improvement has undergone repeat tracheopexy for recurrence. Conclusion: Posterior tracheopexy is an effective treatment option for symptoms associated with tracheomalacia. The thoracoscopic approach is feasible in experienced hands and with the support of a multidisciplinary team.


Assuntos
Toracoscopia/métodos , Traqueia/cirurgia , Traqueomalácia/cirurgia , Broncoscopia , Criança , Pré-Escolar , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Masculino , Recidiva , Estudos Retrospectivos , Traqueia/diagnóstico por imagem , Traqueomalácia/diagnóstico por imagem , Resultado do Tratamento
17.
Fetal Diagn Ther ; 46(1): 75-80, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31238308

RESUMO

We present a case of prenatal hydrops secondary to congenital high airway obstruction syndrome (CHAOS) that was treated with fetoscopy-assisted needle decompression. A 22-year-old G3P2 woman presented after a 21-week ultrasound demonstrated CHAOS. The fetus developed hydrops at 25 weeks, characterized by abdominal ascites, pericardial effusion, and scalp edema. Fetal MRI showed complete obstruction of the glottis and subglottic airway, suggestive of laryngeal atresia. At 27 weeks, due to the progression of the hydrops, operative fetoscopy was proposed and performed. Fetal laryngoscopy confirmed fusion of the vocal cords and laryngeal atresia. The atretic segment was a solid cartilaginous block, preventing intubation. Using the fetoscope to stabilize the fetal head and neck, we performed ultrasound-guided percutaneous needle drainage of the cervical trachea through the anterior fetal neck. We removed 17 mL of viscous fluid from the lower trachea, resulting in immediate lung decompression. Two weeks later, ultrasound confirmed hydrops resolution. The patient was delivered and tracheostomy performed at 30 weeks via an ex utero intrapartum treatment (EXIT) procedure after progression of preterm labor. At 27 days of life, the infant was stable on minimal ventilator support. To our knowledge, this is the first successful report of an ultrasound-guided percutaneous tracheal decompression through the anterior neck of a fetus with CHAOS secondary to laryngeal atresia.


Assuntos
Obstrução das Vias Respiratórias/cirurgia , Hidropisia Fetal/diagnóstico por imagem , Doenças da Laringe/cirurgia , Traqueia/diagnóstico por imagem , Obstrução das Vias Respiratórias/complicações , Feminino , Sofrimento Fetal/complicações , Sofrimento Fetal/diagnóstico por imagem , Sofrimento Fetal/cirurgia , Fetoscopia , Humanos , Lactente , Recém-Nascido , Doenças da Laringe/complicações , Pulmão/diagnóstico por imagem , Gravidez , Traqueostomia , Ultrassonografia Pré-Natal
18.
Dis Model Mech ; 12(6)2019 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-31101657

RESUMO

Cryptococcus neoformans is a leading cause of fungal brain infection, but the mechanism of dissemination and dynamics of cerebral infection following pulmonary disease are poorly understood. To address these questions, non-invasive techniques that can study the dynamic processes of disease development and progression in living animal models or patients are required. As such, bioluminescence imaging (BLI) has emerged as a powerful tool to evaluate the spatial and temporal distribution of infection in living animals. We aimed to study the time profile of the dissemination of cryptococcosis from the lung to the brain in murine models by engineering the first bioluminescent C. neoformans KN99α strain, expressing a sequence-optimized red-shifted luciferase. The high pathogen specificity and sensitivity of BLI was complemented by the three-dimensional anatomical information from micro-computed tomography (µCT) of the lung and magnetic resonance imaging (MRI) of the brain. These non-invasive imaging techniques provided longitudinal readouts on the spatial and temporal distribution of infection following intravenous, intranasal or endotracheal routes of inoculation. Furthermore, the imaging results correlated strongly with the fungal load in the respective organs. By obtaining dynamic and quantitative information about the extent and timing of brain infections for individual animals, we found that dissemination to the brain after primary infection of the lung is likely a late-stage event with a timeframe that is variable between animals. This novel tool in Cryptococcus research can aid the identification of host and pathogen factors involved in this process, and supports development of novel preventive or therapeutic approaches.


Assuntos
Encéfalo/diagnóstico por imagem , Encéfalo/microbiologia , Criptococose/diagnóstico por imagem , Criptococose/microbiologia , Medições Luminescentes , Administração Intranasal , Animais , Encéfalo/patologia , Criptococose/patologia , Modelos Animais de Doenças , Progressão da Doença , Feminino , Luz , Imagem por Ressonância Magnética , Camundongos Endogâmicos BALB C , Traqueia/diagnóstico por imagem , Traqueia/microbiologia , Traqueia/patologia , Microtomografia por Raio-X
19.
Ann Vasc Surg ; 60: 475.e5-475.e10, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31075467

RESUMO

Innominate artery pathology is traditionally treated with open surgical repair and is associated with significant morbidity. No dedicated endovascular solution exists for this anatomic location. We report a series of 3 cases of successful management of innominate artery injuries using an off-label, modified Zenith ESLE stent graft (Cook Medical, Bloomington, IN). Two patients presented with pseudoaneurysms after attempted central venous catheterization, and 1 patient developed a tracheo-innominate fistula. Access was obtained in a retrograde fashion via the right common carotid artery in 2 cases, and via the right axillary artery in the other. Additional anatomic considerations included a prior sternotomy in 2 cases and a bovine arch in 2 cases. Due to the emergent nature of the cases, no cerebral protection maneuvers were taken. The ESLE limbs are of uniform diameter with 3 Z-stent wireforms and measure 55 mm in length. Removal of the distal stent reduces the length to 38 mm. Fourteen- to 18-mm diameter grafts were used. All 3 cases resulted in technical success with complete exclusion of the defect. There were no new neurologic deficits and all patients recovered uneventfully. This approach represents an effective off-label solution for what frequently presents as an emergent problem. In 2 cases, it obviated the need for a complicated redo sternotomy and facilitated endovascular repair in a vessel for which there was no indicated off-the-shelf conduit. Modification of existing devices successfully addressed the need for a nontapered graft of short length and moderate vessel diameter and allowed for minimally invasive treatment of anatomically complex pathology.


Assuntos
Falso Aneurisma/cirurgia , Implante de Prótese Vascular/instrumentação , Prótese Vascular , Tronco Braquiocefálico/cirurgia , Procedimentos Endovasculares/instrumentação , Fístula do Sistema Respiratório/cirurgia , Traqueia , Fístula Vascular/cirurgia , Lesões do Sistema Vascular/cirurgia , Idoso de 80 Anos ou mais , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Tronco Braquiocefálico/diagnóstico por imagem , Tronco Braquiocefálico/lesões , Cateterismo Venoso Central/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Fístula do Sistema Respiratório/diagnóstico por imagem , Fístula do Sistema Respiratório/etiologia , Traqueia/diagnóstico por imagem , Traqueia/lesões , Traqueostomia/efeitos adversos , Resultado do Tratamento , Fístula Vascular/diagnóstico por imagem , Fístula Vascular/etiologia , Lesões do Sistema Vascular/diagnóstico por imagem , Lesões do Sistema Vascular/etiologia
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