RESUMEN
We describe a rare case of fetal mediastinal capillary hemangioma presenting as pleural effusion and a huge pleural occupying lesion during late pregnancy. The patient was admitted at 36 +3 weeks of gestation, with a fetal chest occupying lesion for 11 days. Routine prenatal ultrasound and MRI indicated right pleural effusion and a huge chest occupying lesion in the fetus. The woman was administered oxytocin and delivered a live baby boy at 36 +5 weeks of gestation. The baby was diagnosed as mediastinal hemangioma by postnatal CT, angiography and 3D reconstruction and was discharged after oral propranolol treatment. However, he was readmitted one month after birth due to "pneumonia and tachypnea". After multidisciplinary consultation, the baby underwent a right-side thoracic mediastinal mass resection, and a mediastinal capillary hemangioma was confirmed by pathology. The child continued taking propranolol orally and received regular follow-up and rehabilitation after the operation up to 7 months old, by which time no obvious abnormalities were found.
RESUMEN
Objective:To summarize the effect of thoracoscopy for infants with double aortic arch malformation.Methods:The clinical data of 10 infants with double aortic arch malformation from January 2015 to May 2019 were retrospectively summarized, including 7 boys and 3 girls aged from 2 hours to 8 months, 9 with right arch dominance and 1 with left arch dominance. MRI examination was performed at 35 weeks before birth to understand the relationship between vascular ring and trachea and esophagus. Postnatal surgery was performed when trachea compression exceeded one third, and selective operation was performed around six months after birth if the compression was less than one third.Results:All the 10 cases underwent thoracoscopic surgery, and 1 case underwent thoracotomy because oxygen saturation could not be maintained. The operation time was 80-135 minutes, with an average of 100 minutes. Intraoperative bleeding was about 5-10 ml. Postoperative ventilator support time was 4-14 days. 1 patient was cured and discharged except that he gave up treatment for economic reasons. Postoperative follow-up period was 1-6 months. No difficulty in eating, no difficulty in breathing required tracheal stenosis surgery again. 4 patients needed ventilator support for more than 7 days, 2 patients developed pneumothorax and were cured after drainage. One patient presented hoarseness.Conclusion:Prenatal examination can improve the diagnosis rate of double aortic arch deformity, early intervention follow-up in pediatric surgery can reduce the incidence of related complications in children, and thoracoscopic surgery is feasible to correct the deformity, with small trauma and Less bleeding.