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Capillary hemangioma of the right main bronchus treated by sleeve resection in infancy
K P Paul1, C Börner, K M Müller
1Universitätskinderklinik, Heidelberg, Germany.
Insights
A rare capillary hemangioma caused bronchial obstruction in an infant, leading to respiratory distress. Surgical resection successfully treated the condition, restoring normal lung function.
Area of Science:
- Pediatric Surgery
- Pulmonology
- Vascular Anomalies
Background:
- Infantile respiratory distress can stem from various causes, including rare bronchial obstructions.
- Vascular tumors are uncommon but critical differential diagnoses in pediatric airway compromise.
Observation:
- A 5-month-old infant presented with respiratory distress and right lung hyperinflation.
- Bronchoscopy identified a vascular tumor obstructing the right main bronchus, causing a check-valve effect.
- Radionuclide lung scans revealed significantly reduced ventilation (36%) and perfusion (11%) in the right lung.
Findings:
- Surgical resection of the affected right main bronchus sleeve was performed at 7 months of age.
- Histopathology confirmed a capillary hemangioma measuring 1.2 x 0.6 cm.
- Postoperative recovery was uneventful, with significant improvement in right lung perfusion within 6 months.
Implications:
- Capillary hemangiomas should be considered in the differential diagnosis of pediatric bronchial obstruction.
- Surgical intervention for infantile capillary hemangioma causing airway compromise can be highly successful.
- Early diagnosis and surgical management can lead to complete functional recovery of lung perfusion.
Abstract:
Respiratory distress developed in a 5-month-old female infant with roentgenographic evidence of hyperinflation of the right lung. Bronchoscopy revealed a vascular tumor extending from the medial wall of the right main bronchus leading to a check-valve mechanism. Radionuclide lung scans showed ventilation and perfusion of the right side reduced to 36 and 11% of the total lung ventilation and perfusion, respectively. At the age of 7 months a sleeve of the right main bronchus was resected and a reanastomosis performed. The operation specimen contained a capillary hemangioma measuring 1.2 X 0.6 cm. The postoperative course was uneventful. Perfusion of the right lung had markedly improved 6 months after the operation, and at the age of 2 yr and 9 months it was completely normal. Capillary hemangiomas must be considered a cause of bronchial obstruction in infancy, and surgery can be performed successfully.