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Double aortic arch presenting as severe bronchiolitis in a 2‐week‐old infant
Author(s) -
Griffiths Amanda L,
Massie John,
South Mike
Publication year - 2005
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/j.1440-1754.2005.00615.x
Subject(s) - medicine , stridor , bronchiolitis , respiratory distress , double aortic arch , aortic arch , bronchoscopy , ventilation (architecture) , cardiology , mechanical ventilation , pediatrics , anesthesia , surgery , aorta , respiratory system , airway , mechanical engineering , engineering
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.