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Tracheobronchomegaly following intrauterine tracheal occlusion for congenital diaphragmatic hernia

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Abstract

Background

Fetuses with severe congenital diaphragmatic hernia (CDH) and pulmonary hypoplasia may benefit from fetal endoluminal tracheal occlusion (FETO). Enlargement of the main bronchi and trachea appears to be a common complication of FETO.

Objective

To retrospectively evaluate the trachea and main bronchi of infants who underwent FETO for CDH and compare diameters with age-matched references.

Material and methods

Postnatal and follow-up chest radiographs were performed in seven children with unilateral CDH treated by FETO. Additional CT was performed in six of these (one neonate died before CT could be performed). Images were acquired from 3 days to 23 months of age. For each child, radiographs and CT images with optimal visualisation of the airways were selected for retrospective analysis. Tracheal and bronchial morphology was assessed by two experienced paediatric radiologists, and the diameters of these structures measured and compared with age-matched references.

Results

Mean diameters of the trachea and main bronchi were above the age-matched normal range in all patients, regardless of the side of the hernia or the degree of lung hypoplasia.

Conclusion

Enlargement of the trachea and main bronchi appears following FETO and persists at least to the age of 5 years.

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Acknowledgments

We thank Ms. Christine O’Hara for invaluable help with preparing the manuscript.

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Authors and Affiliations

  1. Department of Pediatric Radiology, Hospital Universitario Vall d’Hebron - AMI, Ps. Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Goya Enriquez, Lina Cadavid, Enrique Garcés-Iñigo, Amparo Castellote & Joaquim Piqueras

  2. Department of Pediatric Surgery, Hospital Universitario Vall d’Hebron, Barcelona, Spain

    Jose Luis Peiró

  3. Department of Obstetrics and Gynecology, Hospital Universitario Vall d’Hebron, Barcelona, Spain

    Elena Carreras

Authors
  1. Goya Enriquez
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  2. Lina Cadavid
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  3. Enrique Garcés-Iñigo
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  4. Amparo Castellote
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  5. Joaquim Piqueras
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  6. Jose Luis Peiró
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  7. Elena Carreras
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Correspondence to Goya Enriquez.

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Enriquez, G., Cadavid, L., Garcés-Iñigo, E. et al. Tracheobronchomegaly following intrauterine tracheal occlusion for congenital diaphragmatic hernia. Pediatr Radiol 42, 916–922 (2012). https://doi.org/10.1007/s00247-012-2362-x

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  • DOI: https://doi.org/10.1007/s00247-012-2362-x

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