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A case of recurrent respiratory infection resulting from a congenital anomaly of the bronchial tree tracheal bronchus

반복적인 호흡기 감염을 가진 환아에서 진단된선천성 기도 기형, 기관기관지 1예

  • Choi, Ah-Reum (Department of Pediatrics, College of Medicine, Kyung Hee University) ;
  • Choi, Sun-Hee (Department of Pediatrics, College of Medicine, Kyung Hee University) ;
  • Kim, Seong-Wan (Department of Otolaryngology, College of Medicine, Kyung Hee University) ;
  • Sung, Dong-Wook (Department of Diagnostic Radiology, College of Medicine, Kyung Hee University) ;
  • Rha, Yeong-Ho (Department of Pediatrics, College of Medicine, Kyung Hee University)
  • 최아름 (경희대학교 의과대학 소아과학교실) ;
  • 최선희 (경희대학교 의과대학 소아과학교실) ;
  • 김성완 (경희대학교 의과대학 이비인후과학교실) ;
  • 성동욱 (경희대학교 의과대학 영상진단의학과교실) ;
  • 나영호 (경희대학교 의과대학 소아과학교실)
  • Received : 2008.01.08
  • Accepted : 2008.03.07
  • Published : 2008.06.15

Abstract

The term tracheal bronchus refers to an abnormal bronchus that comes directly off of the lateral wall of the trachea (above the carina) and supplies ventilation to the upper lobe. Tracheal bronchi occur almost exclusively on the right trachea and are associated with other congenital anomalies. In addition, tracheai bronchus may be related to other inflammatory conditions with persistent wheezing, such as recurrent pneumonia, chronic bronchitis and bronchiectasis, which is a result of the relatively poor local drainage of the involved bronchi. An infant with recurrent wheezing is likely to be a challenge for a clinician in the evaluation of the etiology of airway obstruction and in the differential diagnosis of wheezy breathing. The authors report a case of an 8-month-old female infant with a ventricular septal defect, who presented with stridor and recurrent respiratory infection and finally was finally diagnosed with a tracheal bronchus using computed tomography and a bronchoscopy. Therefore, tracheal bronchus should be included in the differential diagnosis of any child who presents with chronic or recurrent respiratory tract symptoms such as coughing, wheezing, stridor and recurrent respiratory infection, particularly in children with other congenital deformities.

기관기관지는 선천성 기도기형 중 가장 흔한 질환으로, 기관 분기부 상부의 우측 벽에서 기시하는 이소성 부기관지를 말하며, 반복적인 염증성 질환으로 폐렴과 기흉, 기관지 확장증 등을 초래하여 임상적 문제가 되는 경우도 있으나 대부분 기관지내시경검사, 기관지조영술 등을 통해서 우연히 발견된다. 우리는 반복적인 호흡기 감염과 동반되어 나타난 지속적인 천명과 호흡곤란으로 입원치료 중인 환아에서 선천성 기도기형 중 기관기관지를 경험하였으며, 일반 컴퓨터 단층촬영과 삼차원 컴퓨터 단층촬영, 강직형 기관지내시경검사로 이를 확인하였다. 따라서 반복적인 호흡기 감염과, 지속적인 천명을 주소로 내원하는 환아 들에게서 진단의 감별에 있어 선천성 기도기형인 기관기관지의 가능성을 고려해야 하겠다.

Keywords

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