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Traqueoplastia de deslizamento. Uma boa opção na correcção da estenose congénita da traqueia.

By André Graça, Mafalda Lucas, Luísa Pereira, Celeste Barreto, Luísa Lobo, Miroslava Gonçalves, José Matute and Teresa Bandeira

Abstract

When infants with recurrent wheezing have a clinical course inconsistent with a common diagnosis, anatomic malformations should be considered in diagnostic workup, followed by medical stabilization and early therapy. A careful history and physical examination could reveal important diagnostic clues that indicate the need to perform a fiberoptic bronchoscopy, which in the reported case showed tracheal stenosis in the transition between the first and second third of the trachea. Chest CT scan revealed a long funnel-shaped tracheal stenosis and along with an echocardiogram, excluded associated cardiovascular malformations. Surgical correction by sliding tracheoplasty under extra-corporeal circulation was successfully performed at the Hospital Gregório Marañon in Madrid. The surgical complications that have occurred (mediastinitis and pulmonary embolism) were resolved. After a two-year follow-up, that included endoscopic control, the patient was found to be free of symptoms of wheezing or post-surgical complications. The authors emphasize the need for early diagnosis and surgical treatment to be performed in an experienced reference center.When infants with recurrent wheezing have a clinical course inconsistent with a common diagnosis, anatomic malformations should be considered in diagnostic workup, followed by medical stabilization and early therapy. A careful history and physical examination could reveal important diagnostic clues that indicate the need to perform a fiberoptic bronchoscopy, which in the reported case showed tracheal stenosis in the transition between the first and second third of the trachea. Chest CT scan revealed a long funnel-shaped tracheal stenosis and along with an echocardiogram, excluded associated cardiovascular malformations. Surgical correction by sliding tracheoplasty under extra-corporeal circulation was successfully performed at the Hospital Gregório Marañon in Madrid. The surgical complications that have occurred (mediastinitis and pulmonary embolism) were resolved. After a two-year follow-up, that included endoscopic control, the patient was found to be free of symptoms of wheezing or post-surgical complications. The authors emphasize the need for early diagnosis and surgical treatment to be performed in an experienced reference center

Publisher: Ordem dos Médicos
Year: 2004
OAI identifier: oai:ojs.www.actamedicaportuguesa.com:article/1080
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