2021 Not All Who Wheeze Have Asthma - Tracheal Diverticulum with Stenosiis of Trachea In 9 Years Old Boy

Monday, 5 December 2011
Poster Hall (Cancún Center)

Frantisek Kopriva, MD, PhD , Pediatrics, Medical Faculaty, Olomouc, Czech Republic

Background:  

A tracheal diverticulum (TD) is very rare congenital malformation. The prevalence is about 0.3% in children over 10 years of age according to fiberoptic bronchoscope studies and it is rarely reported in clinical practise(3). Here we describe our recent exprience in succesfully diagnosing and treating a 9-years old box suffering from  membranous stenosis of trachey with trachea diverticulum.

Methods:

A 9-year old boy (personal history negative as to trauma of respiratory tract and intubation and atopy) was admitted to hospital with wheezing and progressive dyspnoe during the 6 months to restrict basic locomotion and reading of text. Multislice computed tomography of the chest showed surprising incidental finding of a tracheal diverticulum ( 6mm x  2 mm) and 3-dimensional reconstruction CT stenosis of trachea approximetly 1,5 cm below vocal corde and orificium of tracheal diverticulum ( the 2nd cartilage of trachea). Pulmonary function tests revealed reduction of spirometric values, with no post-bronchodilator change. Subsequent flexible bronchoscopy showed circular stenosis of trachea and orificium of TD. 

Subsequently, the vaporization by  NdYAG laser - Sharplan 3000, with energy of 30 W was performed via flexible bronchoscopy under general anesthesia with a laryngeal mask. The dilatation  by baloon (Boston Scientific) was performed  to widen the diameter of trachea up to 8 mm.

Results:

After one week pulmonary function test revealed normal parameters without pathological symptoms.

Conclusions:

In conclusion, we have summarized the case of an 9-years old boy with membranous stenosis of trachey and trachea diverticulum, a very rare congenital anomaly. This abnormality can be clearly diasgnosed by multislice CT and 3-dimensional reconstruction CT stenosis of trachea. Using the interventional bronchoscopy of membranous circular stenosis of trachea is adequate solution in children too.