Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A case of acute respiratory distress syndrome associated with congenital H-type tracheoesophageal fistula and gastroesophageal reflux

급성호흡곤란증후군을 초래한 위식도역류와 H-형태의 선천기관식도루 1예

  • Chueh, Heewon (Department of Pediatrics, College of Medicine Dong-A University) ;
  • Kim, Myo Jing (Department of Pediatrics, College of Medicine Dong-A University) ;
  • Jung, Jin-A (Department of Pediatrics, College of Medicine Dong-A University)
  • 최희원 (동아대학교 의과대학 소아과학교실) ;
  • 김묘징 (동아대학교 의과대학 소아과학교실) ;
  • 정진아 (동아대학교 의과대학 소아과학교실)
  • Received : 2008.02.08
  • Accepted : 2008.06.20
  • Published : 2008.08.15
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Abstract

H-type tracheoesophageal fistula (TEF) is extremely rare in infants and children, and clinical manifestations of this condition are diverse based on its severity. Some cases of congenital TEF diagnosed in adulthood have been reported, which indicate the difficulty of early diagnosis of this disease. Gastroesophageal reflux (GER) may induce chronic aspiration, pulmonary aspiration, apparent life-threatening events, and failure to thrive. We report a 5-month-old boy whose recurrent pneumonia and wheezing did not improve under usual treatment and led to acute respiratory distress syndrome. He was found to have severe GER on the second-trial of the esophagogram and was eventually revealed to have congenital H-type TEF upon repeated evaluation.

H-형태의 식도기관루 또는 선천 식도 폐쇄 없는 식도 기관루는 소아에서 매우 드문 형태이며, 그 임상 양상도 질환의 중등도에 따라 다양하게 나타난다. 몇몇의 성인에서 발견된 선천 식도 기관루는 이 질환이 조기 진단되기 어려움을 반영한다고 볼 수 있다. 위식도역류는 만성적인 흡인을 일으킬 수 있으며 폐흡인, 생명이 위험할 정도의 호흡기증상 또는 성장장애 등이 흔히 일으킬 수 있는 중한 합병증이다. 저자들은 통상의 치료에 반응을 보이지 않는 반복적인 폐렴과 천명을 동반하고 급성호흡곤란증후군으로까지 진행하였으며 반복된 식도조영촬영에서 심한 위식도역류와 H-형태의 식도기관루가 발견되었던 5개월 남아의 증례를 경험하였기에 이를 보고하는 바이다.

Keywords

Acknowledgement

Supported by : Dong-A University

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