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Radiological Cases of the Month

Radiological Cases of the Month Abstract A male infant was born to a 21-year-old mother (gravida 1, para 1) following pregnancy complicated by transient oligohydramnios at 34 weeks. Shortly after birth, an imperforate anus and passage of meconium through the urethra were noted. A defunctioning transverse colostomy was performed with closure of a rectourethral fistula. Persistent right-upper- and midlung pneumonia developed on day 3 of life (Fig 1) and continued without resolution despite three weeks of intensive antibiotic therapy. Denouement and Discussion Right-Upper-Lobe Esophageal Bronchus (With VATER Anomalies)A barium esophagogram (Fig 2) indicates an anomalous origin from the midthoracic esophagus of a bronchus to the consolidated portion of the right lung. The branching pattern of the bronchi is irregular, and the bronchi are dilated. Free gastroesophageal reflux was present. A bronchogram (Fig 3) shows a smooth tapering constriction of the distal trachea and an elongated, narrowed right bronchus supplying the aerated right lower lobe. An References 1. Gerle RD, Jaretzki A III, Ashley CA, et al: Congenital bronchopulmonary foregut malformation: Pulmonary sequestration communicating with the gastrointestinal tract . N Engl J Med 1968;278:1413-1419.Crossref 2. Vogt EC: Congenital esophageal atresia . AJR 1929;22:463-465. 3. Leithiser RE Jr, Capitanio MA, Macpherson RI, et al: 'Communicating' bronchopulmonary foregut malformations . AJR 1986;146:227-231.Crossref 4. Bleicher MA, Melmed AP, Bogaerts XV, et al: VATER association and unrecognized bronchopulmonary foregut malformation complicating anesthesia . Mt Sinai J Med 1983;50:435-438. 5. Parameswaran A, Krishnaswami H, Walter A: Congenital broncho-oesophageal fistula associated with tracheal agenesis . Thorax 1983;38:551-552.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Radiological Cases of the Month

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References (5)

Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1989.02150140145038
Publisher site
See Article on Publisher Site

Abstract

Abstract A male infant was born to a 21-year-old mother (gravida 1, para 1) following pregnancy complicated by transient oligohydramnios at 34 weeks. Shortly after birth, an imperforate anus and passage of meconium through the urethra were noted. A defunctioning transverse colostomy was performed with closure of a rectourethral fistula. Persistent right-upper- and midlung pneumonia developed on day 3 of life (Fig 1) and continued without resolution despite three weeks of intensive antibiotic therapy. Denouement and Discussion Right-Upper-Lobe Esophageal Bronchus (With VATER Anomalies)A barium esophagogram (Fig 2) indicates an anomalous origin from the midthoracic esophagus of a bronchus to the consolidated portion of the right lung. The branching pattern of the bronchi is irregular, and the bronchi are dilated. Free gastroesophageal reflux was present. A bronchogram (Fig 3) shows a smooth tapering constriction of the distal trachea and an elongated, narrowed right bronchus supplying the aerated right lower lobe. An References 1. Gerle RD, Jaretzki A III, Ashley CA, et al: Congenital bronchopulmonary foregut malformation: Pulmonary sequestration communicating with the gastrointestinal tract . N Engl J Med 1968;278:1413-1419.Crossref 2. Vogt EC: Congenital esophageal atresia . AJR 1929;22:463-465. 3. Leithiser RE Jr, Capitanio MA, Macpherson RI, et al: 'Communicating' bronchopulmonary foregut malformations . AJR 1986;146:227-231.Crossref 4. Bleicher MA, Melmed AP, Bogaerts XV, et al: VATER association and unrecognized bronchopulmonary foregut malformation complicating anesthesia . Mt Sinai J Med 1983;50:435-438. 5. Parameswaran A, Krishnaswami H, Walter A: Congenital broncho-oesophageal fistula associated with tracheal agenesis . Thorax 1983;38:551-552.Crossref

Journal

American Journal of Diseases of Children – American Medical Association

Published: Feb 1, 1989

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