Author(s):
Graça, André 
; Lucas, Mafalda ; Pereira, Luísa ; Barreto, Celeste ; Lobo, Luísa ; Gonçalves, Miroslava ; Matute, José ; Bandeira, Teresa
Date: 2004
Origin: Acta Médica Portuguesa
Document details
Sliding tracheoplasty: a good choice for the treatment of congenital tracheal s...
Description
When infants with recurrent wheezing have a clinical course inconsistent with a common diagnosis, anatomic malformations should be considered in diagnostic workup, followed by medical stabilization and early therapy. A careful history and physical examination could reveal important diagnostic clues that indicate the need to perform a fiberoptic bronchoscopy, which in the reported case showed tracheal stenosis in the transition between the first and second third of the trachea. Chest CT scan revealed a long funnel-shaped tracheal stenosis and along with an echocardiogram, excluded associated cardiovascular malformations. Surgical correction by sliding tracheoplasty under extra-corporeal circulation was successfully performed at the Hospital Gregório Marañon in Madrid. The surgical complications that have occurred (mediastinitis and pulmonary embolism) were resolved. After a two-year follow-up, that included endoscopic control, the patient was found to be free of symptoms of wheezing or post-surgical complications. The authors emphasize the need for early diagnosis and surgical treatment to be performed in an experienced reference center. When infants with recurrent wheezing have a clinical course inconsistent with a common diagnosis, anatomic malformations should be considered in diagnostic workup, followed by medical stabilization and early therapy. A careful history and physical examination could reveal important diagnostic clues that indicate the need to perform a fiberoptic bronchoscopy, which in the reported case showed tracheal stenosis in the transition between the first and second third of the trachea. Chest CT scan revealed a long funnel-shaped tracheal stenosis and along with an echocardiogram, excluded associated cardiovascular malformations. Surgical correction by sliding tracheoplasty under extra-corporeal circulation was successfully performed at the Hospital Gregório Marañon in Madrid. The surgical complications that have occurred (mediastinitis and pulmonary embolism) were resolved. After a two-year follow-up, that included endoscopic control, the patient was found to be free of symptoms of wheezing or post-surgical complications. The authors emphasize the need for early diagnosis and surgical treatment to be performed in an experienced reference center.
When infants with recurrent wheezing have a clinical course inconsistent with a common diagnosis, anatomic malformations should be considered in diagnostic workup, followed by medical stabilization and early therapy. A careful history and physical examination could reveal important diagnostic clues that indicate the need to perform a fiberoptic bronchoscopy, which in the reported case showed tracheal stenosis in the transition between the first and second third of the trachea. Chest CT scan revealed a long funnel-shaped tracheal stenosis and along with an echocardiogram, excluded associated cardiovascular malformations. Surgical correction by sliding tracheoplasty under extra-corporeal circulation was successfully performed at the Hospital Gregório Marañon in Madrid. The surgical complications that have occurred (mediastinitis and pulmonary embolism) were resolved. After a two-year follow-up, that included endoscopic control, the patient was found to be free of symptoms of wheezing or post-surgical complications. The authors emphasize the need for early diagnosis and surgical treatment to be performed in an experienced reference center. When infants with recurrent wheezing have a clinical course inconsistent with a common diagnosis, anatomic malformations should be considered in diagnostic workup, followed by medical stabilization and early therapy. A careful history and physical examination could reveal important diagnostic clues that indicate the need to perform a fiberoptic bronchoscopy, which in the reported case showed tracheal stenosis in the transition between the first and second third of the trachea. Chest CT scan revealed a long funnel-shaped tracheal stenosis and along with an echocardiogram, excluded associated cardiovascular malformations. Surgical correction by sliding tracheoplasty under extra-corporeal circulation was successfully performed at the Hospital Gregório Marañon in Madrid. The surgical complications that have occurred (mediastinitis and pulmonary embolism) were resolved. After a two-year follow-up, that included endoscopic control, the patient was found to be free of symptoms of wheezing or post-surgical complications. The authors emphasize the need for early diagnosis and surgical treatment to be performed in an experienced reference center.
Document Type
Article
Language Portuguese
Language Portuguese
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