Flurin V, Deschildre A, Fourier C, Martinot A, Hue V, Ramon P, Petyt L, Vaksmann G, Leclerc F
Service de réanimation ìnfantile, hôpital Calmette, Lille, France.
Arch Pediatr. 1995 Jun;2(6):555-9. doi: 10.1016/0929-693x(96)81201-2.
Anomalies of the aortic arch and pulmonary arteries may produce compression of the trachea with chronic stridor or wheezing aggravated by crying, feeding and flexion of the neck.
Three infants, 3, 5 and 2 months-old, respectively, were admitted suffering from acute bronchiolitis. The first patient had intermittent wheezing for one month; lateral chest X-rays showed an opaque area inserted between the trachea and oesophagus and computed tomography showed pulmonary artery sling with tracheal stenosis which was successfully operated. The second patient displayed pulmonary atelectasia which required bronchoscopy; this technique showed tracheal stenosis which was due to pulmonary artery sling. The third patient had a history of congenital stridor: he required endotracheal intubation; a bronchoscopy performed because persistent pulmonary atelectasia showed tracheal stenosis which was secondary to a double aortic arch. The condition was improved after surgical correction.
A history of stridor and/or wheezing in patients admitted for bronchiolitis must lead to consider the possibility of vascular compression of the trachea and to perform specific investigations.
主动脉弓和肺动脉异常可能导致气管受压，出现慢性喘鸣或喘息，哭闹、进食及颈部屈曲时症状加重。
分别为3个月、5个月和2个月大的3名婴儿因急性细支气管炎入院。第一名患者间歇性喘息1个月；胸部X线侧位片显示气管与食管之间有一不透明区域，计算机断层扫描显示肺动脉吊带合并气管狭窄，手术成功。第二名患者出现肺不张，需要进行支气管镜检查；该检查显示气管狭窄是由肺动脉吊带引起的。第三名患者有先天性喘鸣病史：他需要进行气管插管；因持续性肺不张进行的支气管镜检查显示气管狭窄，继发于双主动脉弓。手术矫正后病情好转。
因细支气管炎入院的患者如有喘鸣和/或喘息病史，必须考虑气管血管受压的可能性并进行特定检查。
