1. Double aortic arch presenting as severe bronchiolitis in a 2-week-old infant
- Author
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Mike South, John Massie, and Amanda L Griffiths
- Subjects
Double aortic arch ,Victoria ,Stridor ,medicine.medical_treatment ,Aorta, Thoracic ,Diagnosis, Differential ,medicine ,Humans ,Respiratory Sounds ,Mechanical ventilation ,Respiratory distress ,business.industry ,Infant, Newborn ,Vascular ring ,medicine.disease ,Ventilation ,Tracheomalacia ,Exhalation ,Bronchiolitis ,Anesthesia ,Pediatrics, Perinatology and Child Health ,Breathing ,Female ,medicine.symptom ,business - Abstract
A 2-week-old female infant was transferred from a regional hospital for mechanical ventilation after developing severe respiratory distress. Stridor had been present since the age of 1 week and was complicated by coryzal illness. Mechanical ventilation was difficult with marked inspiratory and expiratory flow obstruction recorded by the ventilator. Echocardiogram showed a normal heart. Flexible bronchoscopy revealed mid-tracheal extrinsic compression (unchanged with positive end-expiratory pressure) and advancement of the endotracheal tube by 2 cm completely corrected the flow obstruction. Repeat echocardiogram showed a double aortic arch. This case report emphasizes the importance of clinical history, examination findings and interpretation of the ventilator waveforms in the differential diagnosis of a difficult-to-ventilate infant with bronchiolitis.
- Published
- 2005
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