Department of Pediatric Surgery, West China Hospital, Sichuan University, Guoxue Xiang No.37, Chengdu, 610041, China.
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
BMC Pediatr. 2019 Sep 2;19(1):305. doi: 10.1186/s12887-019-1686-1.
Congenital bronchopulmonary foregut malformation (CBPFM) is a rare congenital malformation involving both the digestive and respiratory system. Early diagnosis is difficult, and delayed recognition may result in considerable complications. The aim of the study was to identify and analyze the clinical characteristics and radiological features of CBPFMs.
A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Ovid database, EMBASE were searched for relevant publications to identify all published case-reports of CBPFM since 1992. Data about the demography, clinical presentation, pathology, imaging features, treatment and prognosis were collected.
Sixty-one cases were included in our study. Cases were aged from 1 day to 59 years with the majority aged 3 years or younger. The most common type was group III (37.7%), followed by group II (29.5%)group I (27.9%) and group IV (4.9%). The presentations included respiratory distress (32.8%), cough/choking following food intake and other presentations associated respiratory infection. Thirty-eight cases (62.3%) were diagnosed by upper gastrointestinal series (UGI). Misdiagnosis was common. Eight cases (13.1%) of the included cases died.
Early recognition and extensive delineation of the anatomy of CBPFM are important to correct these anomalies successfully. UGI is the first choice to confirm the abnormal bronchus communicating with the esophagus. Resection of abnormal pulmonary tissue, lobe or even unilateral lung is preferred. Reconstruction procedures are feasible in selected patients.
先天性支气管肺前肠畸形(CBPFM)是一种罕见的先天性畸形,涉及消化系统和呼吸系统。早期诊断困难,识别延迟可能导致严重并发症。本研究旨在确定和分析 CBPFMs 的临床特征和影像学特征。
按照 PRISMA 指南进行系统综述。检索 PubMed、Ovid 数据库和 EMBASE 以确定自 1992 年以来发表的所有关于 CBPFM 的病例报告。收集有关人口统计学、临床表现、病理学、影像学特征、治疗和预后的数据。
本研究纳入 61 例病例。患者年龄从 1 天到 59 岁不等,大多数年龄在 3 岁以下。最常见的类型是 3 型(37.7%),其次是 2 型(29.5%)、1 型(27.9%)和 4 型(4.9%)。临床表现包括呼吸窘迫(32.8%)、进食后咳嗽/窒息和其他与呼吸道感染相关的表现。38 例(62.3%)通过上消化道造影(UGI)诊断。误诊很常见。纳入的病例中有 8 例(13.1%)死亡。
早期识别和广泛描绘 CBPFM 的解剖结构对于成功纠正这些异常非常重要。UGI 是确认与食管相通的异常支气管的首选方法。首选切除异常肺组织、肺叶甚至单侧肺。在选择的患者中,重建手术是可行的。