YENİDOĞANDA NADİR BİR SOLUNUM SIKINTISI NEDENİ: AKCİĞERLERİN KONJENİTAL KİSTİK ADENOMATOİD MALFORMASYONU

Year 2008, Volume: 9 Issue: 3, 47 - 49, 01.12.2008

Münevver Türkmen Arzu Tanınmış S. Ayvaz Aydoğdu C. Zafer Karaman Harun Gürsoy

Abstract

Yenidoğan döneminde solunum sıkıntısı ile karşılaşıldığında, nadir olarak rastlansa da, akciğerlerin konjenitalanomalilerinin hatırlanması amacıyla bu olgu sunulmuştur. Konjenital kistik adenomatoid malformasyon nadirrastlanan ancak hayatı tehdit eden bir akciğer anomalisidir. Yaklaşık 25000 doğumda bir görülür. Doğumun ilksaatlerinde başlayan solunum sıkıntısı nedeni ile yenidoğan yoğun bakım ünitesine sevk edilen olgunun fizikmuayenesinde solunum sıkıntısı bulguları ve pektus ekskavatus deformitesi mevcuttu. Akciğer grafisinde, solakciğerde kaba retikülogranüler görünümü, toraks bilgisayarlı tomografisinde (BT) sol akciğerde parankimiçerisinde çok sayıda, yaygın, değişik boyutta hava kisti saptandı. BT ve akciğer grafi bulguları ile konjenitalkistik adenomatoid malformasyon Tip III ile uyumlu olarak değerlendirildi. Olgu yaşamının onuncu günündemekanik ventilatörde izlenmekte iken kaybedildi

Keywords

Konjenital kistik adenomatoid malformasyon, yenidoğan, solunum sıkıntısı

The Rare Cause of Respiratory Distress in Newborn: Congenital Cystic Adenomatoid Malformation of Lungs

Abstract

The aim of presenting this case is that; the congenital lung abnormalities are rare, but important of differential diagnosis in newborn respiratory distress.The congenital cystic adenomatoid malformation is a rare but potentially life-threatening pulmonary anomaly. It is reported 1 in 25000 pregnancies. Respiratory distress, pectus excavatus deformity were detected in the physical examination of the infant who was accepted to our newborn intensive care unit in the first hours of his life. In the chest X-ray there was reticulogranular appearance in left lung and there was multiple, diffuse cysts which were in different size in lung parenchyma in the computerize tomography (CT) examination. The signs on the CT and X-ray were accepted as a congenital cystic adenomatoid malformation type III. The case died at his tenth day of the life during assisted mechanical ventilation.

Keywords

Congenital cystic adenomatoid malformation, newborn, respiratory distress

References

• 1. Laberge JM, Flageole H, Pugash D, Khalife S, Blair G, Filiatrault D, Russo P, Lees G, Wilson RD. Outcome of the prenatally diagnosed congenital cystic adenomatoid lung malformation. A Canadian experience. Fetal Diagn Ther 2001; 16: 178-86.
• 2. Reynolds M. Congenital lesions of the lung. In: Shields TW, edito r. Gene ral tho racic su rge ry, Williams&Wilkins, Philadelphia, 1994: 859-74.
• 3. Miller RK, Sieber WK,Yunis EJ. Congenital adenomatoid malformation of the lung: A report of 17 cases and review of the literatüre. In: Sommers SC, Rosen PP, editors. Pathology annual (Part l), Appleton Century Croft, NewYork, 1980: 387-407.
• 4. Wilson RD, Hedrick HL, Liechty KW, Flake AW, Jhonson MP, Bebbington M, Adzick NS. Cystic adenomatoid malformation of the lung: review of genetics, prenatal diagnosis, and in utero treatment.Am J Med GenetA 2006; 140:151-5.
• 5. Davenport M, Warne SA, Cacciaguerra S, Patel S, Greenough A, Nicolaides K. Current outcome of antenatally diagnosed cystic lung disease. J Pediatr Surg 2004; 39:549-56
• 6. Van Raemdonck W, De Boeck K, Devlieger H, Demedts M, Moerman P, Coosemans W, Deneffe G, Lerut T. Pulmonary sequestration: a comparison between pediatric and adult patients. Eur J Cardiotoracic Surg 2001; 19: 388-95.
• 7. Van Leeuwen K, Teitelbaum DH, Hirschl RB, et al. Prenatal diagnosis of congenital cystic adenomatoid malformation and its postnatal presentation, surgical indications, and natural history. J Pediatr Surgery 1999; 34: 794-8.
• 8. Cacciari A, Ceccarelli PL, Pilu GL, et al. A series of 17 cases of congenital cystic adenomatoid malformation of the lung: management and outcome. Eur J Pediatr Surg 1997; 7: 84-9.
• 9. Parikh D, Samuel M. Congenital cystic lung lesions: Is surgical resection essential? Pediatr Pulmonol 2005; 40: 533-7.
• 10. Kravitz RM. Congenital malformations of the lung. Pediatr Clin NorthAm 1994; 41: 453-72.
• 11. Fowler CL, Johnson L, Shukla P, Halverson K. Congenital cystic adenomatoid malformation of the lung. SDJ Med 1987; 40: 5-8.
• 12. Stocker JT, Madewell JE, Drake RM. Congenital cystic adenomatoid malformation of the lung: Clussification and morphologic spectrum. Hum Pathol 1977; 8: 155- 71.
• 13. Lierl M. Congenital abnormalities. In: Hilman BC, editor. Pediatric respiratory disease: diagnosis and treatment,WB Saunders, Philadelphia, 1993: 457-98.
• 14. Adzick NS, Harrison MR, Crombleholme TM, et al. Fetal lung lesions-management and outcome. Am J Obstet Gynecol 1998; 179: 884-9.
• 15. H e b r a A , O t h e r s e n H B , A s h c r a f t E P. Bronchopulmonary malformations. In: KeithW, editor. Pediatric surgery, 3rd ed: WB Saunders Company, Philadelphia, 2000: 277-9.