[Ring-sling complex association with pig bronchus: a pediatric case report]

Area of Science:

• Cardiology
• Pediatric Surgery
• Medical Imaging

Background:

• Pulmonary artery sling is a rare congenital heart defect involving an aberrant left pulmonary artery originating from the right pulmonary artery.
• Congenital tracheal stenosis is a rare airway malformation characterized by a narrowed trachea.
• The ring-sling complex represents an association between these two conditions, posing significant diagnostic and therapeutic challenges.

Observation:

• A pediatric patient presented with inspiratory stridor and respiratory distress.
• Initial evaluation revealed extrinsic tracheal compression, suspected to be a vascular ring.
• CT angiography confirmed pulmonary artery sling, while subsequent surgical endoscopy identified congenital tracheal stenosis and a right accessory bronchus.

Findings:

• The patient was diagnosed with the ring-sling complex, encompassing pulmonary artery sling, congenital tracheal stenosis, and a right accessory bronchus ('pig bronchus').
• Surgical intervention successfully repaired all identified congenital anomalies, including the vascular ring and tracheal stenosis.

Implications:

• This case underscores the critical role of integrated diagnostic approaches, including advanced imaging and direct airway visualization, for managing complex congenital anomalies.
• Simultaneous surgical repair of pulmonary artery sling and congenital tracheal stenosis is feasible and effective.
• Early and accurate diagnosis of the ring-sling complex is essential for preventing severe respiratory complications in affected children.