Three-dimensional computed tomographic findings of bilateral tracheal bronchus.
A newborn male was admitted with cyanosis and respiratory distress. Echocardiography showed a right heart isomerism associated with a single right ventricle, a double-outlet right ventricle, and pulmonary atresia. Chest X-ray demonstrated severe left upper lobe emphysema and a shift of the mediastinal structures to the right. Two-dimensional computed tomography (CT) exhibited left upper lobe emphysema and right upper lobe atelectasis. Three-dimensional (3D) spiral CT angiography showed a bilateral tracheal bronchus. The left tracheal bronchus branch was compressed between the descending aorta and the ductus arteriosus. After a right arteriopulmonary shunt operation, the patient's respiratory condition improved dramatically, with spontaneous closure of the ductus arteriosus. Subsequently, 3D-CT clearly exhibited the disappearance of tracheal compression. This combination of bilateral tracheal bronchus and congenital heart anomaly is extremely rare. The 3D-CT is a powerful noninvasive means for dynamically demonstrating the special relationships of arterial and tracheal anomalies.
Watabnabe
Kazuhiro
K
Department of Pediatrics, University of Toyama, Toyama, Japan.
Uese
Keiichirou
K
Higuchi
Osamu
O
Futatani
Takeshi
T
Yoshimura
Naoki
N
Nakamura
Tsuneyuki
T
Ichida
Fukiko
F
D001980:Bronchi / Q000002:abnormalities*; D001995:Bronchography; D003490:Cyanosis / Q000209:etiology*; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012127:Respiratory Distress Syndrome, Newborn / Q000000981:diagnostic imaging* / Q000473:pathology; D014056:Tomography, X-Ray; D014132:Trachea / Q000002:abnormalities* / Q000000981:diagnostic imaging