Pulmonary Artery Sling: A Rare Cause of Recurrent Aspiration Pneumonia

Pulmonary artery sling is the rarest vascular ring anomaly that left pulmonary artery originates from posterior of right pulmonary artery with an abnormal course and ends in hilus of the left lung. A Six months old girl was brought to our emergency unit for cough, dyspnea, and cyanosis which were started after feeding. She was hospitalized with the diagnosis of aspiration pneumonia and solid food remnants were aspirated from the left main bronchus by bronchoscopy. In her second hospitalization when she was 15 months old, pulmonary artery sling was seen in her thoracic tomography and was corrected by surgery. Hypoplasia and compression of left main bronchus were also noted in her thoracic tomography. She was 22 months old on her last visit and is followed by our outpatient clinic without any problems. Recurrent wheezing episodes, brassy cough, chronic stridor, vomiting, and dysphagia are the main presenting signs and symptoms of pulmonary artery sling. PAS diagnosis is rare for recurrent aspiration pneumonia. Due to abnormal course of the left pulmonary artery it presses over trachea or right pulmonary artery. The presentation of this case was considered for its atypical anatomy and clinical presentation. (Journal of Current Pediatrics 2013;11:81-4