ABSTRACT
Four male patients with pulmonary arterio-venous fistulae are reported. Familiar occurrence was noticed in 2 brothers. Physiological effects, clinical pictures and treatment of these lesions depend on the size and number of the fistulae. A 4-day-old baby presented with severe cyanosis and cardiomegaly. Cardiac catheterization and angiography demonstrated a large arterio-venous fistula affecting the whole of the right upper lobe and a small ventricular septal defect resulting in a high output cardiac failure. The patient underwent emergency lobectomy with good early and long-term results. The other 3 patients (mean age of 7.6 years) developed progressive cyanosis and polycythemia. Cardiac catheterization showed normal intracardiac pressures and peripheral arterial desaturation. Pulmonary angiogram demonstrated multiple fistulae in both lungs. Surgery was not performed because of the diffuse nature of the lesions. The patients reported in this paper illustrate the wide spectrum of clinico-pathological conditions of this anomaly.
Subject(s)
Arteriovenous Malformations/surgery , Pulmonary Artery/abnormalities , Pulmonary Veins/abnormalities , Adolescent , Adult , Arteriovenous Malformations/diagnostic imaging , Arteriovenous Malformations/pathology , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Pneumonectomy , RadiographyABSTRACT
Seven children, aged 4 months to 10 years, with bronchial compression due to tuberculous hilar lymphadenitis have been treated surgically since 1974. The indications for surgical treatment were lack of response to chemotherapy and in particular the development of respiratory distress. Excision or curettage of the affected nodes was found to be a safe and sure method of relieving the acute symptoms and preventing permanent damage to the lung.
