RESUMO
The determination of the exact cause for symptomatic airway obstruction in pediatric patients not responding to medication can be a clinical dilemma. Very rarely external vascular compressions can produce airway obstruction symptoms unresponsive to usual bronchodilator medications. The successful management of a child with pulmonary atresia and an innominate artery compression syndrome with respiratory compromise due to tracheal compression is described.
Assuntos
Atresia Pulmonar/complicações , Sons Respiratórios/etiologia , Arteriopatias Oclusivas/complicações , Arteriopatias Oclusivas/cirurgia , Tronco Braquiocefálico , Broncodilatadores/uso terapêutico , Broncoscopia , Feminino , Humanos , Lactente , Atresia Pulmonar/diagnóstico por imagem , Atresia Pulmonar/cirurgia , Doença Pulmonar Obstrutiva Crônica/etiologia , Traqueia/diagnóstico por imagem , Procedimentos Cirúrgicos VascularesRESUMO
Tracheal stenosis refers to a reduction in the size of the tracheal lumen and can be due to a myriad of reasons, but the most common remains trauma. In iatrogenic situations, internal trauma is the most likely culprit, resulting from prolonged intubation. Our case reviews a patient who developed severe tracheal stenosis (90% reduction in lumen size) within a month of a threeday- long intubation, and presented to the emergency room with dyspnea, orthopnea, and stridor. Tracheal reconstruction with resection of the stenosed segment and end-to-end anastomosis was done. The patient returned a month later with re-stenosis, and underwent tracheal dilatation. Subsequently, he was discharged with a tracheostomy with no problems thereafter.