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Primary bronchomalacia and patent ductus arteriosus: simultaneous surgical correction in an infant
V Ahel1, S Severinski, D Vukas
1Pediatric Clinic, Pulmonary Unit, Faculty of Medicine, University of Rijeka, Croatia.
Insights
A rare case of a 6-month-old girl with recurrent lung infections and wheezing due to a collapsed left main bronchus and patent ductus arteriosus was successfully treated with surgical repair.
Area of Science:
- Pediatric Pulmonology
- Congenital Heart Disease
- Thoracic Surgery
Background:
- Recurrent pediatric respiratory infections and persistent wheezing can indicate underlying airway or cardiac anomalies.
- Patent ductus arteriosus (PDA) is a common congenital heart defect, but its association with bronchial anomalies is rare.
Observation:
- A 6-month-old female presented with recurrent left lung infections and wheezing.
- Imaging revealed left lung hyperinflation, atelectasis, and a collapsed left main bronchus segment.
- Echocardiography confirmed a patent ductus arteriosus.
Findings:
- Surgical intervention involved closing the PDA and performing a bronchopexy, securing the left main bronchus to the PDA tissue.
- The patient experienced no postoperative complications.
Implications:
- This case highlights a unique combination of congenital anomalies requiring a combined surgical approach.
- Successful surgical repair led to complete resolution of respiratory symptoms and normal follow-up.
- This case expands understanding of rare pediatric airway and cardiac malformations.
Abstract:
We report the clinical course of a 6-month-old girl with recurrent infection of the left lung, persistent wheezing, and a suspected congenital heart anomaly (patent ductus arteriosus. Chest radiography revealed hyperinflation and slight inflammation of the left lung. Tracheobronchoscopy and left-sided bronchography showed a collapsed segment of the left main bronchus, 3 cm long. Computed tomography confirmed hyperinflation of the left lung and atelectasis of the superior lobe. There were no signs of extramural compression. Color-flow Doppler echocardiography confirmed the suspicion of patent ductus arteriosus. To the best of our knowledge, there is no other report in the literature of a patient with this combination of anomalies. After receiving 2 weeks of antibiotic treatment, the patient underwent surgical repair The patent ductus arteriosus was closed by means of a triple-ligature procedure, and during the same operation a bronchopexy was performed, securing the left main bronchus to the closed ductus tissue by means of sutures. There have been no complications in the postoperative period. Clinical follow-up, as well as echocardiography and bronchoscopy, have yielded normal results 14 months after surgery.