دورية أكاديمية
[Double aortic arch and aortotracheal fistula as cause of fatal massive bleeding: a rare and dangerous association].
العنوان: | [Double aortic arch and aortotracheal fistula as cause of fatal massive bleeding: a rare and dangerous association]. |
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عنوان ترانسليتريتد: | Doble arco aórtico y fistula aortotraqueal como causa de hemorragia masiva fatal: una asociación rara y peligrosa. |
المؤلفون: | Ramos PH; Departamento de Otorrinolaringología, Pontificia Universidad Católica de Chile, Santiago, Chile., Cabello P; Departamento de Otorrinolaringología, Pontificia Universidad Católica de Chile, Santiago, Chile., Contreras A; Departamento de Neonatología, Pontificia Universidad Católica de Chile, Santiago, Chile., Albrich D; Departamento de Otorrinolaringología, Pontificia Universidad Católica de Chile, Santiago, Chile., Toso A; Departamento de Neonatología, Pontificia Universidad Católica de Chile, Santiago, Chile. |
المصدر: | Andes pediatrica : revista Chilena de pediatria [Andes Pediatr] 2024 Feb; Vol. 95 (1), pp. 84-90. |
نوع المنشور: | English Abstract; Journal Article |
اللغة: | Spanish; Castilian |
بيانات الدورية: | Publisher: Sociedad Chilena de Pediatría Country of Publication: Chile NLM ID: 101778868 Publication Model: Print Cited Medium: Internet ISSN: 2452-6053 (Electronic) Linking ISSN: 24526045 NLM ISO Abbreviation: Andes Pediatr Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: [Santiago, Chile] : Sociedad Chilena de Pediatría, [2021]- |
مواضيع طبية MeSH: | Vascular Ring*/complications , Vascular Ring*/surgery , Esophageal Fistula*/diagnosis , Esophageal Fistula*/etiology , Esophageal Fistula*/surgery, Humans ; Infant, Newborn ; Gastrointestinal Hemorrhage/etiology |
مستخلص: | Vascular rings are unusual congenital malformations. Among them, double aortic arch (DAA) is often difficult to diagnose due to its low incidence of symptoms. DAA can be associated with tracheal or esophageal compression and, in severe cases, could require tracheal intubation or chronic use of a nasogastric tube. This scenario favors the development of aortotracheal fistulas (ATF) or aortoe-sophageal fistulas (AEF). Objective: To present a clinical case with an unusual association of DAA with ATF and to reinforce the importance of maintaining high diagnostic suspicion in patients with massive aerodigestive bleeding without an obvious source. Clinical Case: A 32-week preterm newborn who required prolonged mechanical ventilation and presented intermittent episodes of massive oropharyngeal bleeding with hemodynamic compromise associated with lower airway obstruction without pulmonary hemorrhage. The patient underwent upper endoscopy and exploratory laparotomy without evidence of bleeding. Flexible nasopharyngolaryngoscopy and direct laryngoscopy also showed no abnormalities. A CT angiography showed complete DAA with indentation of the left dominant arch over the trachea, without severe stenosis or evidence of a fistula. AEF was suspected, so exploratory surgery was considered. However, the patient died before surgery due to a massive pulmonary hemorrhage. The autopsy revealed the presence of ATF. Conclusions: In patients with massive aerodigestive bleeding without an obvious source, the presence of DAA and possible AEF/ ATF should be considered. Imaging studies have a poor performance for this diagnosis, so surgery should be considered for diagnosis and treatment in these patients. |
تواريخ الأحداث: | Date Created: 20240408 Date Completed: 20240409 Latest Revision: 20240409 |
رمز التحديث: | 20240409 |
DOI: | 10.32641/andespediatr.v95i1.5005 |
PMID: | 38587348 |
قاعدة البيانات: | MEDLINE |
تدمد: | 2452-6053 |
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DOI: | 10.32641/andespediatr.v95i1.5005 |