Moriuchi Yuko, Fuchigami Tatsuo, Mizukoshi Waka, Morioka Ichiro
Department of Pediatrics, IMS Fujimi General Hospital, Saitama, JPN.
Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, JPN.
Cureus. 2022 May 6;14(5):e24771. doi: 10.7759/cureus.24771. eCollection 2022 May.
In this case report, we describe the case of an infant with repeated wheezing diagnosed relatively early with congenital tracheal and bronchial stenosis after evaluation by chest three-dimensional computed tomography (3D-CT). The patient was a six-month-old male infant with a one-month history of cough and wheezing. His symptoms worsened the day before admission, and he was admitted with pneumonia and wheezing. However, wheezing continued after treatment with intravenous steroids and inhalation of a short-acting β2-stimulant. 3D-CT of the chest revealed tracheal stenosis, right bronchial stenosis, and right tracheobronchial bronchus. The patient was finally diagnosed with congenital tracheal and bronchial stenosis via bronchoscopy. A virtual bronchoscopic navigation image of the tracheal lumen was created based on the CT images. Although virtual bronchoscopic navigation is more difficult for the dynamic evaluation and evaluation of mucosal lesions than bronchoscopy, it has the advantage of not directly invading the airway. Therefore, if a fixed stenotic lesion is suspected at a facility where bronchoscopy is difficult, evaluation using chest 3D-CT and virtual bronchoscopic navigation may be helpful for diagnosis. In conclusion, congenital tracheal/bronchial stenosis should be considered in patients with prolonged wheezing and recurrent airway infections, and evaluation by chest 3D-CT and virtual bronchoscopic navigation may be helpful for diagnosis.
在本病例报告中,我们描述了一例反复喘息的婴儿病例,该婴儿在接受胸部三维计算机断层扫描(3D-CT)评估后,较早被诊断为先天性气管支气管狭窄。患者为一名6个月大的男婴,有1个月的咳嗽和喘息病史。入院前一天症状加重,因肺炎和喘息入院。然而,静脉注射类固醇和吸入短效β2激动剂治疗后喘息仍持续。胸部3D-CT显示气管狭窄、右支气管狭窄和右气管支气管。最终通过支气管镜检查诊断为先天性气管支气管狭窄。基于CT图像创建了气管腔的虚拟支气管镜导航图像。虽然虚拟支气管镜导航在动态评估和黏膜病变评估方面比支气管镜检查更困难,但它具有不直接侵入气道的优点。因此,如果在难以进行支气管镜检查的机构怀疑存在固定性狭窄病变,使用胸部3D-CT和虚拟支气管镜导航进行评估可能有助于诊断。总之,对于喘息持续时间长和反复发生气道感染的患者,应考虑先天性气管/支气管狭窄,胸部3D-CT和虚拟支气管镜导航评估可能有助于诊断。