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Han Z, Yu T, Huang J, Liu D, Fu L, Yang S, Peng Y. Computed tomography findings of communicating bronchopulmonary foregut malformation: a retrospective study of 18 patients. Pediatr Radiol 2023; 53:1063-1075. [PMID: 36847802 DOI: 10.1007/s00247-023-05610-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Communicating bronchopulmonary foregut malformation is a rare anomaly characterized by a patent congenital communication between the esophagus or stomach and an isolated portion of the respiratory system. An esophagogram is taken as the gold standard for diagnosis. Compared with esophagography, computed tomography (CT) is more widely used and easily obtained, but CT findings have been described as nonspecific. PURPOSE To describe CT findings in 18 patients with communicating bronchopulmonary foregut malformation to assist with early diagnosis. MATERIAL AND METHODS A retrospective review of 18 patients who had proven communicating bronchopulmonary foregut malformation between January 2006 and December 2021 was conducted. For each patient, the medical records, including demographics, clinical manifestations, upper gastrointestinal radiography, magnetic resonance imaging and CT findings, were reviewed. RESULTS Among the 18 patients, there were 8 males. The right to left ratio was 3.5:1. An entire lung was involved in 10 patients, a lobe or a segment was involved in 7 patients and an ectopic lesion was located in the right neck in 1 patient. The isolated lung may arise from the upper esophagus, mid-esophagus, lower esophagus or stomach, which were detected in 1, 3, 13, and 1 patient, respectively. On chest CT, an extra bronchus which did not arise from the trachea was detected in 14 patients. Contrast-enhanced chest CT was performed in 17 patients, the isolated lung receiving its blood supply from the pulmonary artery in 13 patients, the systemic artery in 11 patients and both pulmonary and systemic arteries in 7 patients. CONCLUSIONS The presence of an extra bronchus, which does not arise from the trachea, highly suggests the diagnosis of communicating bronchopulmonary foregut malformation. Contrast-enhanced chest CT can provide accurate information regarding the airways, lung parenchyma and vascular structures that is useful to plan surgery.
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Affiliation(s)
- Zhonglong Han
- Department of Radiology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, No. 56, Nanlishilu Road, Xicheng District, Beijing, 100045, People's Republic of China
| | - Tong Yu
- Department of Radiology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, No. 56, Nanlishilu Road, Xicheng District, Beijing, 100045, People's Republic of China
| | - Jinshi Huang
- Department of Neonatal Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Dingyi Liu
- Department of Thoracic Surgery, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Libing Fu
- Department of Pathology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Shuangfeng Yang
- Department of Radiology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, No. 56, Nanlishilu Road, Xicheng District, Beijing, 100045, People's Republic of China
| | - Yun Peng
- Department of Radiology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, No. 56, Nanlishilu Road, Xicheng District, Beijing, 100045, People's Republic of China.
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Yang G, Chen L, Xu C, Yuan M, Li Y. Congenital bronchopulmonary foregut malformation: systematic review of the literature. BMC Pediatr 2019; 19:305. [PMID: 31477056 PMCID: PMC6721191 DOI: 10.1186/s12887-019-1686-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/22/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Congenital bronchopulmonary foregut malformation (CBPFM) is a rare congenital malformation involving both the digestive and respiratory system. Early diagnosis is difficult, and delayed recognition may result in considerable complications. The aim of the study was to identify and analyze the clinical characteristics and radiological features of CBPFMs. METHODS A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Ovid database, EMBASE were searched for relevant publications to identify all published case-reports of CBPFM since 1992. Data about the demography, clinical presentation, pathology, imaging features, treatment and prognosis were collected. RESULTS Sixty-one cases were included in our study. Cases were aged from 1 day to 59 years with the majority aged 3 years or younger. The most common type was group III (37.7%), followed by group II (29.5%)group I (27.9%) and group IV (4.9%). The presentations included respiratory distress (32.8%), cough/choking following food intake and other presentations associated respiratory infection. Thirty-eight cases (62.3%) were diagnosed by upper gastrointestinal series (UGI). Misdiagnosis was common. Eight cases (13.1%) of the included cases died. CONCLUSIONS Early recognition and extensive delineation of the anatomy of CBPFM are important to correct these anomalies successfully. UGI is the first choice to confirm the abnormal bronchus communicating with the esophagus. Resection of abnormal pulmonary tissue, lobe or even unilateral lung is preferred. Reconstruction procedures are feasible in selected patients.
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Affiliation(s)
- Gang Yang
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Guoxue Xiang No.37, Chengdu, 610041, China
| | - Lina Chen
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Chang Xu
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Guoxue Xiang No.37, Chengdu, 610041, China
| | - Miao Yuan
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Guoxue Xiang No.37, Chengdu, 610041, China
| | - Yuan Li
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Guoxue Xiang No.37, Chengdu, 610041, China.
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Ota Y, Watanabe T, Takahashi K, Suda T, Tachibana S, Matsubayashi J, Nagakawa Y, Osaka Y, Katsumata K, Tsuchida A. Bronchogenic cyst removal via thoracoscopic surgery in the prone position: A case report and literature review. Int J Surg Case Rep 2019; 60:204-208. [PMID: 31233965 PMCID: PMC6597694 DOI: 10.1016/j.ijscr.2019.05.064] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 05/21/2019] [Accepted: 05/30/2019] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Mediastinal bronchogenic cysts are encountered relatively often, but in many cases, diagnosis using imaging modalities, is difficult. Early surgical excision of bronchogenic cysts is recommended as a diagnostic and therapeutic measure. Here, we report the case of patient with a lower mediastinal bronchogenic cyst, who was treated using thoracoscopic surgery with prone positioning and include a review of literature on diagnosis and treatment of this condition. PRESENTATION OF CASE The patient was a 66-year-old woman with an asymptomatic cystic lesion in the posterior, lower mediastinum. The lesion was diagnosed as an esophageal cyst using preoperative imaging and was scheduled for thoracoscopic removal with the patient in the prone position. Intraoperatively, the lesion was found to have no continuity with the esophageal wall and was easily separated from it. Moreover, a cord extending to the lesion, appeared to arise from the crura of the diaphragm. On histopathological examination of the extracted mass, the lesion was diagnosed as a bronchogenic cyst. Postoperatively, the patient recovered uneventfully and was discharged after 7 days. CONCLUSION Thoracoscopic mediastinal cystectomy with the patient in the prone position may be an optimal surgical strategy for the treatment of bronchogenic cysts in the posterior, lower mediastinum.
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Affiliation(s)
- Yoshihiro Ota
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan.
| | - Takafumi Watanabe
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kosuke Takahashi
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Takeshi Suda
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Shingo Tachibana
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Jun Matsubayashi
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Yuichi Nagakawa
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Yoshiaki Osaka
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kenji Katsumata
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Akihiko Tsuchida
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
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