Recurrent croup in a young child: look beyond airways disease

2021 ◽  
Vol 14 (2) ◽  
pp. e236605
Author(s):  
Saurav Jain ◽  
Taruna Yadav ◽  
Prawin Kumar ◽  
Jagdish Prasad Goyal
Keyword(s):  
Left Lung ◽  
Rare Condition ◽  
Lung Field ◽  
Ct Angiogram ◽  
Breath Sounds ◽  
Cardiac Apex ◽  
Right Pulmonary Artery ◽  
Chest Examination ◽  
Pulmonary Arterial ◽  
The Right

We reported here a boy aged 5 years who presented for the evaluation of recurrent croup since infancy. On chest examination, breath sounds were reduced throughout the right lung field with a shifting of the trachea and cardiac apex to the right side. The chest radiograph showed a small right lung with decreased vascularity, hyperinflated left lung and mediastinum shifted towards the right side. Flexible bronchoscopy revealed tracheomalacia with left bronchomalacia due to external pulsatile compression. In CT angiogram, the right pulmonary artery (PA) was absent with dilated left PA. Echocardiography did not show any features of pulmonary arterial hypertension (PAH). Since the child was growing well, and there was no limitation of activity and evidence of PAH, he was managed conservatively and kept on follow-up. Though unilateral absent PA is a rare condition, it should be suspected in children with unilateral hypoplastic lung.

scholarly journals A Case of Congenital Bronchial Pulmonary Arterial Malformation Successfully Treated by Embolization

2018 ◽  
Vol 02 (03) ◽  
pp. 201-204
Author(s):  
Ferdinand Chu ◽  
Ko Sit ◽  
King Kwok
Keyword(s):  
Bronchial Artery ◽  
Effective Means ◽  
Rare Condition ◽  
Embolic Material ◽  
Right Pulmonary Artery ◽  
Pulmonary Arterial ◽  
The Right ◽  
Arterial Malformation ◽  
Right Bronchial Artery

AbstractIdiopathic bronchial pulmonary arterial malformation (BPAM) is a very rare condition. The authors present a case of BPAM in which a right bronchial artery communicates with a main upper lobe branch of the right pulmonary artery. It was successfully treated by embolization in one setting. The patient remained asymptomatic and well during the follow-up period. The authors therefore conclude that if the embolic material/device is carefully chosen, it is a safe and effective means of treating BPAM.

Severe stenosis of a long tracheal segment, with agenesis of the right lung and left pulmonary arterial sling

2006 ◽  
Vol 16 (1) ◽  
pp. 89-91 ◽  
Author(s):  
Hamish M. Munro ◽  
Andrea M. C. Sorbello ◽  
David G. Nykanen
Keyword(s):  
Pulmonary Artery ◽  
Surgical Repair ◽  
Main Bronchus ◽  
Left Lung ◽  
Proximal Part ◽  
Pulmonary Vasculature ◽  
Severe Stenosis ◽  
Right Pulmonary Artery ◽  
Pulmonary Arterial ◽  
The Right

A baby presented at term with respiratory distress was managed with extracorporeal membrane oxygenation. Bronchoscopy revealed tracheal hypoplasia, complete tracheal rings, and agenesis of the right main bronchus. Echocardiography showed a left pulmonary arterial sling arising from the proximal part of the right pulmonary artery. Cardiac catheterization demonstrated abnormal pulmonary vasculature in the left lung which would have prevented survival, even after surgical repair. Diagnostic catheterization was important in delineating the anatomy, and aided in the decision not to proceed with surgical repair.

Incidental finding of pulmonary arterial sling during patent ductus arteriosus surgery in a patient with Mowat–Wilson syndrome

2018 ◽  
Vol 28 (8) ◽  
pp. 1074-1076 ◽  
Author(s):  
Juan D. Cano Sierra ◽  
Camilo F. Mestra ◽  
Miguel A. Ronderos Dumit
Keyword(s):  
Pulmonary Artery ◽  
Incidental Finding ◽  
Ductus Arteriosus ◽  
Left Lung ◽  
Posterior Wall ◽  
Left Pulmonary Artery ◽  
Genetic Condition ◽  
Right Pulmonary Artery ◽  
Pulmonary Arterial ◽  
The Right

AbstractMowat–Wilson syndrome is a genetic condition due to a mutation in the ZEB2 gene; it affects many systems including the cardiovascular system. The pulmonary arterial sling originates from a failure of development of the proximal portion of the left sixth aortic arch, resulting in an anomalous left pulmonary artery origin from the posterior wall of the right pulmonary artery and the left pulmonary artery crossing to the left lung between the trachea and the oesophagus. We present a 4-month-old infant with Mowat–Wilson syndrome and left pulmonary arterial sling, and discuss the association of these two rare conditions. Pulmonary arterial sling is significantly more frequent in patients with Mowat–Wilson syndrome than in the general population.

scholarly journals The First of Congenital Cystic Adenomatoid Lung Malformation in Iraq: A Radiologic and Pathologic Study

2020 ◽  
Vol 1 (1) ◽  
pp. 01-03
Author(s):  
Aamir Mosawi
Keyword(s):  
Respiratory Distress ◽  
Left Lung ◽  
Rare Condition ◽  
Male Infant ◽  
Congenital Cystic Adenomatoid Malformation ◽  
Lung Field ◽  
Microscopical Examination ◽  
Pulmonary Tissue ◽  
Cystic Adenomatoid Malformation ◽  
The Right

Background: Congenital cystic adenomatoid lung malformation is a very rare condition characterized by replacement of normal pulmonary tissue with cysts of variable size and distribution. The condition is usually unilateral. Very few cases of bilateral and congenital cystic adenomatoid malformation with good outcome after resections of the lesions have been reported, and most cases were stillborn or died early during life. Patients and methods: A forty-day male infant presented with progressive respiratory distress since the first week of life observed at the Children Teaching Hospital of Baghdad Medical City was studied. The literature was reviewed with aim of describing the early documentation of the condition in the literature. Results: Clinically, the infant had significant respiratory distress interfering with feeding and evidence of shift of the mediastinum to the right. Chest X ray showed increased translucency of left lung field and mediastinal shit to the right. CT-scan showed large air-filled cyst in the left lung and small air-filled cyst in the right lung. The child was treated successfully by left upper lobecomy. The gross examination of two gray pieces of lung tissue showed on cut section microcysts that were apparent grossly. Microscopical examination showed intercommunicating cysts lined by cuboidal epithelium with gland like appearance confirming the diagnosis of congenital cystic adenomatoid malformation of the lung. Conclusion: A very rare case of bilateral congenital cystic adenomatoid malformation of the lung is reported and the early documentation of the condition in the literature is described.

Spontaneous renal artery dissection: an elusive diagnosis

2021 ◽  
Vol 14 (9) ◽  
pp. e245949
Author(s):  
Catherine Mary Henry ◽  
Peter MacEneaney ◽  
Gemma Browne
Keyword(s):  
Renal Artery ◽  
Antihypertensive Treatment ◽  
Rare Condition ◽  
Acute Onset ◽  
Flank Pain ◽  
Artery Dissection ◽  
Renal Infarction ◽  
Ct Angiogram ◽  
Systemic Anticoagulation ◽  
The Right

Spontaneous renal artery dissection is a rare condition with an often non-specific presentation, resulting in a challenging diagnosis for clinicians. This is the case of a 39-year-old man who presented with an acute-onset right flank pain, mild neutrophilia and sterile urine. CT of abdomen and pelvis showed a patchy hypodense area in the right kidney originally thought to represent infection. He was treated as an atypical pyelonephritis with antibiotics and fluids. When his symptoms failed to improve, a diagnosis of renal infarction was considered and CT angiogram of the aorta revealed a spontaneous renal artery dissection. He was managed conservatively with systemic anticoagulation, antihypertensive treatment and analgesia and discharged home with resolution of his symptoms and normal renal function.

Chronic lung lymph fistula that only drains the left lung

1995 ◽  
Vol 269 (4) ◽  
pp. R943-R947
Author(s):  
Y. Kikuchi ◽  
H. Nakazawa ◽  
D. L. Traber
Keyword(s):  
Arterial Pressure ◽  
Pulmonary Arterial Pressure ◽  
Mediastinal Lymph Node ◽  
Pulmonary Veins ◽  
Pulmonary Arteries ◽  
Left Lung ◽  
Lymph Flow ◽  
Pulmonary Arterial ◽  
The Right ◽  
Arteries And Veins

We developed a chronic lung fistula that drains only the left lung, allowing for evaluation of injury in a single lung. To remove lymph drainage from the right lung into the caudal mediastinal lymph node, the right lower pulmonary ligament was severed. Pneumatic occluders were placed on the left pulmonary arteries and veins. To ensure that lymph drained from only the left lung, we increased the right pulmonary arterial pressure (RPAP) from 21.2 +/- 0.5 to 36.5 +/- 0.6 mmHg. The left pulmonary arterial pressure (LPAP) was kept at wedge pressure level for 1 h by inflating pneumatic occluders. Lymph flow from the left lung fistula was stable during this occlusion. Six hours after recovery was increased the LPAP from a baseline level of 19.1 +/- 1.0 to 36.4 +/- 0.9 mmHg and the RPAP from 21.2 +/- 0.5 to 38.0 +/- 0.8 mmHg for 2 h by inflating the pneumatic occluders on the left and right pulmonary veins. Lymph flow increased from 5.3 +/- 1.0 to 28.0 +/- 2.9 ml/h. Reflection coefficient was calculated at 0.80 +/- 0.02.

Systemic arterial supply of the right lung with venous drainage to the pulmonary arterial circuit

2011 ◽  
Vol 21 (6) ◽  
pp. 710-712 ◽  
Author(s):  
Peter Fritsch ◽  
Freyja-Maria Smolle-Juettner ◽  
Andreas Gamillscheg
Keyword(s):  
Pulmonary Artery ◽  
Venous Drainage ◽  
Left Pulmonary Artery ◽  
Scimitar Syndrome ◽  
Arterial Supply ◽  
Respiratory Problems ◽  
Right Pulmonary Artery ◽  
Pulmonary Arterial ◽  
The Right ◽  
Systemic Arterial Supply

AbstractIn a girl suffering from “Scimitar syndrome”, a rerouting of the scimitar vein was performed at the age of 6 years, but no embolisation of the aberrant systemic vessel was done. She presented with recurring respiratory problems 13 years later. An angiography revealed an invert flow from the aberrant systemic vessel via the right pulmonary artery into the left pulmonary artery. After pneumonectomy, she recovered well.

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