Vasküler Halka Nedeniyle Solunum Arresti Gelişen İnfant: Ayna Görüntüsü Dallanması ile Sağ Arkus Aorta ve Sol Ligamentum Arteriosum

Yıl 2014, Cilt: 12 Sayı: 3, 175 - 178, 01.12.2014

Ali Yıldırım , Pelin Köşger Gökmen Özdemir Tevfik Demir Birsen Uçar Zübeyir Kılıç

https://doi.org/10.4274/jcp.43531

Öz

Vasküler halka aortik ark ve pulmoner arterin, trakea ve özefagusa değişen derecelerde bası yaparak solunum ve beslenme problemlerine neden olabilen bir anomali grubudur. En sık saptanan tipi double aortik arktır. Hastalarda değişen şiddetlerde öksürük, dispne, inspiratuvar stridor, disfaji ve solunum yetersizliği görülür. Solunum güçlüğü, hırıltılı solunum ve öksürük nedeniyle başvurduğu hastanede pnömoni tanısı konan 15 günlük erkek bebek hasta yatırılmış. Antiobiyotik tedavisi başlanan hasta şikayetlerinin gerilememesi ve solunum arresti gelişmesi üzerine tarafımıza yönlendirildi. Yapılan değerlendirilmesinde ayna görüntüsü hayali dallanması ile sağ arkus aorta ve sol ligamentum arteriosum tespit edildi. Hastanın trakea ve özefagusunda değişen şiddetlerde bası mevcuttu. Opere edilen hastanın trakeal kompresyon sonucu gelişen trakeomalaziye bağlı şikayetleri devam etti. Postoperatif 43. günde pnömoni ve sepsis nedeniyle hasta kaybedildi. Bu hasta ile özellikle infant ve erken çocukluk döneminde acil servise kronik öksürük, stridor ve hırıltı gibi tekrarlayan solunum şikayetleri ve solunum arresti ile başvuran hastalarda vasküler ringin ayrıcı tanıda yer alması gerekliliği vurgulanmak istendi

Anahtar Kelimeler

Vasküler ring, ayna görüntüsü dallanması ile sağ arkus aorta, sol ligamentum arteriosum

Respiratory Arrest in Infant Secondary to Vascular Ring; Mirror Image Branching with Right Aortic Arch and Left Ligamentum Arteriosum

Öz

Vascular ring is a group of abnormalities that may cause respiratory and feeding problems with varying degrees of compression on the trachea and esophagus by the aortic arch and pulmonary artery. Cough, dyspnea, inspiratory stridor, dysphagia and respiratory failure are seen in these patients at varying intensities. The 15 days old male baby who had difficulty in breathing, had wheezing and coughing was diagnosed with pneumonia and was hospitalized. The patient was referred to us upon developing respiratory arrest. Mirror image branching with right arcus aorta and left ligamentum arteriosum was detected. Trachea and eosophagus of the patient were compressed at varying intensities. Symptoms of the patient related with tracheobronchomalacia which developed due to tracheal compression continued after operation. Patient died on the postoperative day 43 after developing pneumonia and sepsis. With this patient emphasis was placed on the necessity of vascular ring should be in the differential diagnosis in infant and early childhood patients applying with recurrent respiratory symptoms such as wheezing, chronic cough, stridor and those applying with respiratory arrest to the emergency department

Anahtar Kelimeler

Vascular ring, mirror image branching with right aortic arch, left ligamentum arteriosum

Kaynakça

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