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Neonatal respiratory distress syndrome revealing a cervical bronchogenic cyst: a case report.

Thaller P, Blanchet C, Badr M, Mesnage R, Leboucq N, Mondain M, Cambonie G - BMC Pediatr (2015)

Bottom Line: Proximal esophageal stenosis induced transient upper airway obstruction with salivary stasis.Decannulation was performed at 2 months and the patient was discharged 10 days later.In those situations, tracheostomy may be necessary for mechanical ventilation weaning and the initiation of oral feeding.

View Article: PubMed Central - PubMed

Affiliation: Department of Neonatology and Pediatric Intensive Care Unit, Hôpital Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France. p-thaller@chu-montpellier.fr.

ABSTRACT

Background: Bronchogenic cyst is a congenital malformation, rarely located in the cervical region and almost never involved in a neonate with acute respiratory distress in the delivery room.

Case presentation: A female newborn with respiratory distress syndrome caused by a large left cervical mass. Intubation was difficult due to tracheal deviation. Magnetic resonance imaging confirmed a left cervical cyst displacing the trachea and esophagus laterally. Surgical excision was performed via a cervical approach on the 5th day, and pathological examination revealed a bronchogenic cyst. The patient's course was complicated by left vocal cord paralysis and necrotic lesions in the glottic and subglottic regions; she required a tracheostomy on the 13th day. Inflammatory stenosis in the subglottic region required balloon dilation once, 20 days later. Proximal esophageal stenosis induced transient upper airway obstruction with salivary stasis. Decannulation was performed at 2 months and the patient was discharged 10 days later.

Conclusion: A bronchogenic cyst can exceptionally obstruct the airways in the neonatal period. Surgical excision is necessary, but postoperative complications may occur if the cyst is in close contact with the trachea and esophagus, including necrotic and stenotic lesions of the upper aerodigestive tract. In those situations, tracheostomy may be necessary for mechanical ventilation weaning and the initiation of oral feeding.

No MeSH data available.


Related in: MedlinePlus

Cervical thoracic MRI. Coronal T1-weighted sequence showing a voluminous left laterocervical mass displacing the trachea (a) and carotid-jugular axis (b). Axial T2-weighted sequence showing tracheal compression (a) and esophageal compression (b) by the cyst
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Fig1: Cervical thoracic MRI. Coronal T1-weighted sequence showing a voluminous left laterocervical mass displacing the trachea (a) and carotid-jugular axis (b). Axial T2-weighted sequence showing tracheal compression (a) and esophageal compression (b) by the cyst

Mentions: On admission, the newborn was ventilated in assist-control pressure mode with FiO2 set at 21 %. Clinical examination confirmed a noninflammatory cervical swelling that was soft on palpation. Chest x-ray revealed the endotracheal tube deflected to the right with respect to the spinal axis. Cervical US showed a thin-walled cystic mass measuring 24 × 28 × 37 mm displacing the trachea and the left thyroid lobe medially and forward, and the carotid and jugular vessels laterally and posteriorly. MRI identified a large cystic mass with well-defined walls that laterally displaced the aerodigestive tract (Fig. 1).Fig. 1


Neonatal respiratory distress syndrome revealing a cervical bronchogenic cyst: a case report.

Thaller P, Blanchet C, Badr M, Mesnage R, Leboucq N, Mondain M, Cambonie G - BMC Pediatr (2015)

Cervical thoracic MRI. Coronal T1-weighted sequence showing a voluminous left laterocervical mass displacing the trachea (a) and carotid-jugular axis (b). Axial T2-weighted sequence showing tracheal compression (a) and esophageal compression (b) by the cyst
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4491209&req=5

Fig1: Cervical thoracic MRI. Coronal T1-weighted sequence showing a voluminous left laterocervical mass displacing the trachea (a) and carotid-jugular axis (b). Axial T2-weighted sequence showing tracheal compression (a) and esophageal compression (b) by the cyst
Mentions: On admission, the newborn was ventilated in assist-control pressure mode with FiO2 set at 21 %. Clinical examination confirmed a noninflammatory cervical swelling that was soft on palpation. Chest x-ray revealed the endotracheal tube deflected to the right with respect to the spinal axis. Cervical US showed a thin-walled cystic mass measuring 24 × 28 × 37 mm displacing the trachea and the left thyroid lobe medially and forward, and the carotid and jugular vessels laterally and posteriorly. MRI identified a large cystic mass with well-defined walls that laterally displaced the aerodigestive tract (Fig. 1).Fig. 1

Bottom Line: Proximal esophageal stenosis induced transient upper airway obstruction with salivary stasis.Decannulation was performed at 2 months and the patient was discharged 10 days later.In those situations, tracheostomy may be necessary for mechanical ventilation weaning and the initiation of oral feeding.

View Article: PubMed Central - PubMed

Affiliation: Department of Neonatology and Pediatric Intensive Care Unit, Hôpital Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France. p-thaller@chu-montpellier.fr.

ABSTRACT

Background: Bronchogenic cyst is a congenital malformation, rarely located in the cervical region and almost never involved in a neonate with acute respiratory distress in the delivery room.

Case presentation: A female newborn with respiratory distress syndrome caused by a large left cervical mass. Intubation was difficult due to tracheal deviation. Magnetic resonance imaging confirmed a left cervical cyst displacing the trachea and esophagus laterally. Surgical excision was performed via a cervical approach on the 5th day, and pathological examination revealed a bronchogenic cyst. The patient's course was complicated by left vocal cord paralysis and necrotic lesions in the glottic and subglottic regions; she required a tracheostomy on the 13th day. Inflammatory stenosis in the subglottic region required balloon dilation once, 20 days later. Proximal esophageal stenosis induced transient upper airway obstruction with salivary stasis. Decannulation was performed at 2 months and the patient was discharged 10 days later.

Conclusion: A bronchogenic cyst can exceptionally obstruct the airways in the neonatal period. Surgical excision is necessary, but postoperative complications may occur if the cyst is in close contact with the trachea and esophagus, including necrotic and stenotic lesions of the upper aerodigestive tract. In those situations, tracheostomy may be necessary for mechanical ventilation weaning and the initiation of oral feeding.

No MeSH data available.


Related in: MedlinePlus