Assuntos
Insuficiência Adrenal/diagnóstico , Doenças do Sistema Nervoso Autônomo/diagnóstico , Acalasia Esofágica/diagnóstico , Insuficiência Adrenal/genética , Insuficiência Adrenal/fisiopatologia , Doenças do Sistema Nervoso Autônomo/genética , Doenças do Sistema Nervoso Autônomo/fisiopatologia , Criança , Pré-Escolar , Acalasia Esofágica/genética , Acalasia Esofágica/fisiopatologia , Feminino , Humanos , Hipotensão Ortostática , Lactente , Inteligência , Síndrome , Lágrimas/metabolismoRESUMO
We report the clinical course of a 6-month-old girl with recurrent infection of the left lung, persistent wheezing, and a suspected congenital heart anomaly (patent ductus arteriosus. Chest radiography revealed hyperinflation and slight inflammation of the left lung. Tracheobronchoscopy and left-sided bronchography showed a collapsed segment of the left main bronchus, 3 cm long. Computed tomography confirmed hyperinflation of the left lung and atelectasis of the superior lobe. There were no signs of extramural compression. Color-flow Doppler echocardiography confirmed the suspicion of patent ductus arteriosus. To the best of our knowledge, there is no other report in the literature of a patient with this combination of anomalies. After receiving 2 weeks of antibiotic treatment, the patient underwent surgical repair The patent ductus arteriosus was closed by means of a triple-ligature procedure, and during the same operation a bronchopexy was performed, securing the left main bronchus to the closed ductus tissue by means of sutures. There have been no complications in the postoperative period. Clinical follow-up, as well as echocardiography and bronchoscopy, have yielded normal results 14 months after surgery.
