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Pulmonary Artery Sling Presenting as Pneumonia and Inhalation of a Foreign Body
1Hunan Children's Hospital, Changsha, China.
Insights
Pulmonary artery sling (PAS), a rare congenital anomaly, causes respiratory distress by compressing the airway. Surgical correction and infection prophylaxis successfully resolved symptoms in an infant case.
Area of Science:
- Pediatric Cardiology
- Thoracic Surgery
- Congenital Malformations
Background:
- Pulmonary artery sling (PAS) is a rare congenital anomaly.
- It causes respiratory distress due to aberrant left pulmonary artery origin compressing the trachea and right mainstem bronchus.
- Often associated with recurrent respiratory infections and tracheal anomalies.
Observation:
- An infant presented with respiratory distress and recurrent infections.
- Initial surgery for a foreign object did not resolve symptoms.
- Bronchoscopy revealed bronchus stenosis; echocardiogram and CT confirmed PAS.
Findings:
- Surgical correction of PAS and bronchus stenosis was successful.
- Symptoms of respiratory distress resolved post-surgery.
- Incidence of respiratory infections decreased after intervention.
Implications:
- Early diagnosis and surgical intervention are crucial for managing PAS.
- Combined surgical repair and prophylactic treatment can improve outcomes.
- This case highlights the importance of considering rare congenital anomalies in persistent respiratory distress.
Abstract:
Pulmonary artery sling is a rare cause of respiratory distress created by compression of the lower trachea and right mainstem bronchus due to an aberrant origin of the left pulmonary artery. The condition is frequently associated with recurrent respiratory infections and other congenital malformations including tracheal rings. We present the case of an infant presenting with pulmonary distress and a history of recurrent respiratory infection. The infant underwent surgery to remove a foreign object; however, the symptoms did not resolve. Bronchoscopy revealed bronchus stenosis, and subsequent echocardiogram and CT scans revealed the presence of a pulmonary artery sling. We prescribed infection prophylaxis with the immunomodulator OM-85 to mitigate the risk of further infections prior to surgery. PAS and bronchus stenosis were corrected successfully by surgical intervention leading to resolution of symptoms of respiratory distress and a reduction in the incidence of respiratory infection.
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