Yerman H M, Holinger L D
Department of Otolaryngology-Head & Neck Surgery, University of Illinois College of Medicine, Chicago.
Ann Otol Rhinol Laryngol. 1990 Feb;99(2 Pt 1):89-93. doi: 10.1177/000348949009900201.
Bronchogenic cysts are uncommon developmental anomalies of the primitive foregut that can produce symptoms of ventilatory compromise in infants and children. A 2-month-old child presented with episodes of stridor and obstructive apnea due to a bronchogenic cyst compressing the trachea and causing near-total obstruction. Aspiration of the cyst during bronchoscopy resulted in severe bradycardia (from 140 to 50 beats per minute), although blood pressure was stable and oxygen saturation remained at 100%. Subsequent elective thoracotomy revealed the cyst to be intimately associated with the vagus nerve, and vagal stimulation may have caused the bradycardia. Bronchogenic cysts, although rare, should be considered in the differential diagnosis of infants and children undergoing direct laryngoscopy and bronchoscopy for airway compromise. The endoscopic aspiration of cystic tracheal and bronchial lesions may not obviate the need for more definitive surgical treatment and, as this case demonstrates, is not free of potential hazard.
支气管源性囊肿是原始前肠罕见的发育异常，可在婴幼儿中产生通气功能受损的症状。一名2个月大的儿童因支气管源性囊肿压迫气管并导致近乎完全阻塞，出现喘鸣和阻塞性呼吸暂停发作。支气管镜检查时囊肿抽吸导致严重心动过缓（从每分钟140次降至50次），尽管血压稳定且氧饱和度保持在100%。随后的择期开胸手术显示囊肿与迷走神经密切相关，迷走神经刺激可能导致了心动过缓。支气管源性囊肿虽然罕见，但在对因气道受损接受直接喉镜和支气管镜检查的婴幼儿进行鉴别诊断时应予以考虑。囊性气管和支气管病变的内镜抽吸可能无法消除更明确手术治疗的必要性，并且如本病例所示，并非没有潜在风险。
