Yenidoğanda Nadir Görülen Bir Solunum Sıkıntısı olgusu: Kistik Adenomatoid Malformasyon
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2017
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info:eu-repo/semantics/openAccess
Özet
Amaç: Konjenital kistik adenomatoid malformasyon (CCAM), displastik ve/veya hamartamatöz akciğer dokusunun, immatür bronş ağacından anormal dallanmasıyla oluşan, nadir görülen konjenital bir akciğer anomalisidir. İnsidansı 25-30 bin gebelikte birdir ve sıklıkla erkek bebekleri etkiler. Bu vaka sunumunda nadir görülen CCAM'ın tartışılması ve hatırlatılması amaçlandı.Olgu: Yirmi sekiz yaşında anneden 37. gestasyonel haftasında vajinal doğumla 2090 gr olarak doğan bebeğin 1 ve 5. dk. Apgar değerlendirmesi sırasıyla 9 ve 10 idi. Takiplerinde hipoglisemi gelişen ve beslenememe şikayeti olan hastanın Yenidoğan Yoğun Bakım Servisi'ne yatışı yapıldı. Yatışının altıncı gününde solunum sayılarının artmaya başlaması üzerine çekilen PA akciğer filminde sol üst lobda kistik görünüm izlendi. Tomografide sol akciğerde üst lobda, inferiora hafif uzanımıda gözlenen, en büyüğünün çapı yaklaşık 1,3 cm ölçülen birbirine yakın komşulukta multipl kistik oluşumlar saptandı. Kistik oluşumların boyutları 2 cm altında olması nedeniyle CCAM tip 2 ile uyumlu olarak değerlendirildi . Sonuç: Yenidoğan döneminde etyolojisi saptanamayan solunum sıkıntısı varlığında nadir gözükse de CCAM akılda tutulmalıdır. Hayatın ilk dönemlerinde çekilen PA akciğer filmi doğal olarak değerlendirilse bile kistlerin içinde sıvı olabileceğinden tanı dışlanamaz. Kist veya kistlerin oluşturacağı etki ve klinik duruma göre cerrahi tedavinin ne zaman yapılacağına karar verilmelidir.
Aim: Congenital cystic adenomatoid malformation (CCAM) is a rare congenital lung anomaly which is charecterized by an abnormal branching of dysplastic or hamartomatous lung tissue from the immature bronchial tree. Its incidence is one of 25-30 thousand gestations and CCAM most commonly affects male infants. We aim to discuss and remind the rare CCAM with a case report.Case presentation: An (male, female) infant which had delivered at 37th gestational week from twenty-eight-year-old mother following vaginal delivery, his or her weight was 2.090 kg. Apgar scores were 9 and 10 at 1st and 5th min, respectively. Because of hypoglycemia and inability to feed, newborn was admitted to Neonatal Intensive Care Unit. A cystic formation was observed at the upper lobe of left lung on Posterior Anterior lung graphy which was taken due to the increasement of respiratory rate. Multiple cystic formations were observed in the upper lobe of the left lung in computerized tomography evaluation. These cysts were close to each other, slightly lengthened to inferior region and largest cyst was measured about 1.3 cm in diameter. Because of the size of the cystic formations was less than 2 cm, this case was evaluated as type 2-CCAM. Conclusions: In the presence of undefined neonatal respiratory distress, CCAM should be considered even if it appears as a rare disease. In spite of PA chest film taken in the early stages of life is evaluated as normal, the diagnosis can not be excluded because of cysts filled with fluid. Depending on the effects and clinical situations of the cysts, time of operation should be managed.
Aim: Congenital cystic adenomatoid malformation (CCAM) is a rare congenital lung anomaly which is charecterized by an abnormal branching of dysplastic or hamartomatous lung tissue from the immature bronchial tree. Its incidence is one of 25-30 thousand gestations and CCAM most commonly affects male infants. We aim to discuss and remind the rare CCAM with a case report.Case presentation: An (male, female) infant which had delivered at 37th gestational week from twenty-eight-year-old mother following vaginal delivery, his or her weight was 2.090 kg. Apgar scores were 9 and 10 at 1st and 5th min, respectively. Because of hypoglycemia and inability to feed, newborn was admitted to Neonatal Intensive Care Unit. A cystic formation was observed at the upper lobe of left lung on Posterior Anterior lung graphy which was taken due to the increasement of respiratory rate. Multiple cystic formations were observed in the upper lobe of the left lung in computerized tomography evaluation. These cysts were close to each other, slightly lengthened to inferior region and largest cyst was measured about 1.3 cm in diameter. Because of the size of the cystic formations was less than 2 cm, this case was evaluated as type 2-CCAM. Conclusions: In the presence of undefined neonatal respiratory distress, CCAM should be considered even if it appears as a rare disease. In spite of PA chest film taken in the early stages of life is evaluated as normal, the diagnosis can not be excluded because of cysts filled with fluid. Depending on the effects and clinical situations of the cysts, time of operation should be managed.
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