[A case of congenital tracheal stenosis with tracheomalacia due to esophageal remnants].
We report a case of congenital tracheal stenosis with tracheomalacia, which shows unique histological findings. A 1056 g male infant was delivered by cesarean section for fetal asphyxia at 28 wk of gestation. Immediately after birth, he had frequent apneic spells and required intubation and ventilation for 70 days. After he was discharged at 240 days of age, he had occasional apneic spells and was resuscitated by his family doctor. When he was admitted to our hospital at 11 months of age, he had a respiratory rate of 32 breaths/min with retractions, and auscultation revealed biphasic wheezes. Chest X-ray and bronchoscope examination showed a stenotic and malacic section of the upper trachea. When he was 1 year and 2 months old, an operation was performed. The diseased portion was resected and end-to-end anastomosis with interrupted absorbable suture was performed. The postoperative course was uneventful and he was discharged from our hospital on the 46th postoperative day. Histologically, the cartilaginous ring was composed of some islets of cartilage. Furthermore, there were some striated muscle cells on the inside of the incomplete cartilaginous ring. To our knowledge, this finding has never been reported in earlier papers. We suppose that some of the visceral mesenchymal tissue which should form the esophagus became sequestered in the tracheal region before the esophageal and tracheal tubes completely separated.
Namura
O
O
Second Department of Surgery, Niigata University School of Medicine, Japan.
Hirono
T
T
Yamato
Y
Y
Nakayama
K
K
Tsuchida
M
M
Eguchi
S
S
D002357:Cartilage Diseases / Q000151:congenital*; D004947:Esophagus / Q000002:abnormalities*; D006801:Humans; D007223:Infant; D008297:Male; D014133:Tracheal Diseases / Q000151:congenital*; D014135:Tracheal Stenosis / Q000151:congenital*