Ben Abdallah Rabiaa, Bouthour Habib, Hellal Youssef, Ben Malek Mohamed Riadh, Gharbi Youssef, Kaabar Nejib
Service de chirurgie pédiatrique, hôpital Habib Thameur, Tunis, Tunisie, Faculté de Médecine de Tunis, Université Tunis El Manar.
Tunis Med. 2013 Jan;91(1):66-9.
Congenital broncho-pulmonary malformations (CBM) are rare, essentially presented by congenital lobar emphysema, bronchogenic cysts, pulmonary sequestrations and cystic adenomatoid malformations. The diagnosis can be in prenatal. In postnatal, symptoms are variable. Radiological investigations lead to diagnosis in all cases.
To study the principal clinic, radiologic and therapeutic of the congenital broncho-pulmonary malformations through ten cases.
Retrospective study of 10 cases of congenital bronchopulmonary malformations diagnosed between 2003 and 2010 in our institution.
The mean ages at the time of diagnosis is 2 months (4 days to 16 months). The sex ratio is 1. The symptoms consisted of recurrent pneumonia in 4 cases, respiratory distress in 2cases, bronchiolite in 2 cases and 2 cases of antenatal diagnosis. All patients have a chest X-ray, night patients have a chest computerized tomography and one patient has a bronchial endoscopy. Ten cases of BPM have been investigated: five congenitals lobar emphysema, tow pulmonary sequestrations, tow cystic adénomatoid malformation and one bronchogenic cyst. Eight patients required surgical treatment involving pneumonectomy (1 case), lobectomy (5 cases),segmentectomy (1 case) and in 1 case the pulmonary sequestration was treated by ligature of the anomalous artery with pulmonary resection. The histopathological examination confirmed the diagnosis in all cases. The postoperative period was uneventful in 8 cases with a mean of follow-up of 2 years (5 months to 5years). Tow patient died after surgical treatment.
The diagnosis of BPM malformations can be clinical, confirmed by radiological investigations. The improvement in prenatal ultrasound diagnosis modified the management strategy. The treatment varies frome attitude conservatrice to pneumonectomy.
先天性支气管肺发育畸形(CBM)较为罕见,主要表现为先天性大叶性肺气肿、支气管囊肿、肺隔离症和囊性腺瘤样畸形。其诊断可在产前进行。产后症状多样。所有病例均通过影像学检查得以诊断。
通过10例病例研究先天性支气管肺发育畸形的主要临床、放射学及治疗情况。
对2003年至2010年在我院诊断的10例先天性支气管肺发育畸形病例进行回顾性研究。
诊断时的平均年龄为2个月(4天至16个月)。性别比为1。症状包括4例反复肺炎、2例呼吸窘迫、2例细支气管炎以及2例产前诊断病例。所有患者均进行了胸部X线检查,部分患者进行了胸部计算机断层扫描,1例患者进行了支气管内镜检查。共研究了10例BPM:5例先天性大叶性肺气肿、2例肺隔离症、2例囊性腺瘤样畸形和1例支气管囊肿。8例患者需要手术治疗,包括全肺切除术(1例)、肺叶切除术(5例)、肺段切除术(1例),1例肺隔离症通过结扎异常动脉并进行肺切除治疗。组织病理学检查在所有病例中均证实了诊断。8例患者术后恢复顺利,平均随访2年(5个月至5年)。2例患者术后死亡。
BPM畸形的诊断可通过临床诊断,并经影像学检查证实。产前超声诊断的改善改变了治疗策略。治疗方法从保守治疗到全肺切除术不等。