ABSTRACT
We report on a tuberculous child whose only presenting symptom was acute hemoptysis. His chest radiograph revealed a mass-like lesion occupying the posterior basal segment of the right lower lung field. Multidetector computerized tomography (MDCT) of the chest showed a hypodense mass supplied by the bronchial artery and drained by the pulmonary vein. Surgical specimens revealed caseating granulomatous inflammation, positive for acid-fast bacilli. The child was successfully treated with a short-course (6-month) regimen of antituberculous drugs.
Subject(s)
Hemoptysis/etiology , Tuberculosis, Pulmonary/diagnosis , Acute Disease , Antitubercular Agents/therapeutic use , Child, Preschool , Hemoptysis/surgery , Humans , Male , Patient Compliance , Radiography, Thoracic , Tomography, X-Ray Computed , Treatment Outcome , Tuberculosis, Pulmonary/complications , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/surgeryABSTRACT
The authors present the case of a 2-month-old infant with double aortic arch that developed massive bright red upper gastrointestinal hemorrhage from aortoesophageal fistula (AEF) after prolonged endotracheal and nasogastric intubation. Emergency thoracotomy with AEF and double aortic arch repaired were done successfully under cardiopulmonary bypass. Due to tracheomalacia and left phrenic nerve injury, tracheal extubation could not be done until 1 month after correction of the vascular ring. The endotracheal and nasogastric tube led to fistula formation by compression of the esophageal wall against an abnormal double aortic arch. When a double aortic arch is suspected, prolonged nasogastric intubation should be avoided.
