Tekrarlayan Aspirasyon Pnomonisinin Nadir Bir Nedeni: Pulmoner Arter Sling

Year 2013, Volume: 11 Issue: 2, 81 - 84, 01.09.2013

Abdullah Özyurt , Ali Baykan Ertuğrul Mavili Faruk Serhatlıoğlu Mustafa Argun Kazım Uzum Nazmi Narin

https://doi.org/10.4274/Jcp.11.29491

Abstract

Pulmoner arter sling PAS , sol pulmoner arterin sağ pulmoner arter arka kısmından köken alarak anormal seyirle sol akciğer hilusunda sonlandığı en nadir vasküler ring anomalisidir. Altı aylık bir kız olgu beslenmeyi takiben öksürük, nefes darlığı, hırıltı ve morarma şikâyetleriyle acil ünitemize getirildi. Aspirasyon pnömonisi tanısı ile yatırılan olgunun sol ana bronşundan bronkoskopiyle katı yemek artıkları çıkarıldı. Onbeş aylıkken aynı şikâyetlerle ikinci başvurusunda çekilen toraks tomografisiyle PAS tanısı konuldu. Toraks tomografisinde ayrıca sol ana bronş basısı ve hipoplazisi vardı. On beş aylıkken cerrahi yolla slingi düzeltildi. Cerrahi sonrası solunum ve beslenme şikâyetleri olmadı. En son kontrolünde 22 aylık olan hasta polikliniğimizde sorunsuz olarak izlenmektedir. Pulmoner arter sling, daha çok tekrarlayan wheezing atakları, inatçı öksürük, kronik stridor, kusma ve disfaji gibi şikâyet ve bulgularla başvurur. Tekrarlayan aspirasyon pnomonisi kliniğinde PAS tanısı nadirdir. Anormal seyirli sol pulmoner arter, seyri nedeniyle trakea veya sağ pulmoner artere bası yapar. Olgu atipik anatomisi ve prezantasyonu nedeniyle sunulmuştur

Keywords

Sling, tekrarlayan aspirasyon pnomonisi, stridor, pulmoner arter

Pulmonary Artery Sling: A Rare Cause of Recurrent Aspiration Pneumonia

Abstract

Pulmonary artery sling is the rarest vascular ring anomaly that left pulmonary artery originates from posterior of right pulmonary artery with an abnormal course and ends in hilus of the left lung. A Six months old girl was brought to our emergency unit for cough, dyspnea, and cyanosis which were started after feeding. She was hospitalized with the diagnosis of aspiration pneumonia and solid food remnants were aspirated from the left main bronchus by bronchoscopy. In her second hospitalization when she was 15 months old, pulmonary artery sling was seen in her thoracic tomography and was corrected by surgery. Hypoplasia and compression of left main bronchus were also noted in her thoracic tomography. She was 22 months old on her last visit and is followed by our outpatient clinic without any problems. Recurrent wheezing episodes, brassy cough, chronic stridor, vomiting, and dysphagia are the main presenting signs and symptoms of pulmonary artery sling. PAS diagnosis is rare for recurrent aspiration pneumonia. Due to abnormal course of the left pulmonary artery it presses over trachea or right pulmonary artery. The presentation of this case was considered for its atypical anatomy and clinical presentation

Keywords

Sling, recurrent aspiration pneumonia, stridor, pulmonary artery

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