Samboni Yuli T, Tordecilla Liliana P, Acuña Gilberto, Muñoz Ana L
Facultad de Medicina, Universidad Antonio Nariño, Bogotá, Colombia.
Facultad de Ciencias, Universidad Antonio Nariño, Bogotá, Colombia.
Arch Argent Pediatr. 2020 Apr;118(2):e170-e173. doi: 10.5546/aap.2020.e170.
Pulmonary arteriovenous fistulas are congenital malformations due to anomalous direct communication between arteries and veins; the incidence is 2-3 : 100,000 inhabitants. This condition is usually asymptomatic and incidentally appearing in adult imaging findings. Transcutaneous endovascular embolization is the technique of choice for treatment. The unusual presentation in a 10-year-old patient is described; she was presented to the Emergency Department with dyspnea, cough, central cyanosis and digital clubbing; chest X-ray with images suggestive of parahilar nodules, arterial blood gases with increased alveolar arterial gradient. The high resolution computed tomography of the thorax revealed pulmonary arteriovenous malformation in the right parahilar region not associated with Rendu-Osler- Weber disease. The patient was treated with transcutaneous endovascular embolization, and after a year and a half of follow-up there were no relapses. There are few reported cases of pulmonary arteriovenous fistulas in the pediatric age.
肺动静脉瘘是由于动脉和静脉之间异常直接连通而导致的先天性畸形;发病率为每10万居民中有2 - 3例。这种情况通常无症状,在成人影像学检查结果中偶然发现。经皮血管内栓塞术是首选的治疗技术。本文描述了一名10岁患者的罕见表现;她因呼吸困难、咳嗽、中心性发绀和杵状指被送往急诊科;胸部X线显示提示肺门旁结节的影像,动脉血气分析显示肺泡动脉梯度增加。胸部高分辨率计算机断层扫描显示右肺门旁区域存在肺动静脉畸形,与遗传性出血性毛细血管扩张症无关。该患者接受了经皮血管内栓塞治疗,经过一年半的随访,未出现复发。小儿年龄组肺动静脉瘘的报道病例很少。