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STRIDOR I ASPIRACIONA PNEUMONIJA ODOJČETA UZROKOVANI KONGENITALNOM CISTOM BAZE JEZIKA /
STRIDOR AND ASPIRATION PNEUMONIA IN INFANT CAUSED BY CONGENITAL TONGUE BASE CYST

Authors

 

Dejana Bajić1, Dragica Bulajić2, Ljiljana Ristovski1, Nikola Eić1, Nataša Kovač1

1Institut za zdravstvenu zaštitu dece i omladine Vojvodine, Novi Sad, Srbija
2Univerzitet u Novom Sadu, Medicinski fakultet

 

UDK: 616.24-053.31
616.313-003.4-053.31


The paper was received / Rad primljen: 23.10.2019

Accepted / Rad prihvaćen: 06.12.2019.

 


Correspondence to:


Dr Dejana Bajić
Institut za zdravstvenu zaštitu dece i omladine Vojvodine,
Klinika za pedijatriju
Hajduk Veljkova 10
21 000 Novi Sad, Srbija
Telefon: +381606231290
e-mail: dejnadeki@gmail.com

 

 

Sažetak

 

Uvod: Stridor u novorođenačkom i odojačkom uzrastu je indikator opstrukcije na nivou gornjih disajnih puteva. Kongenitalne ciste baze jezika su retke,  a zbog kompresivnog efekta na epiglotis mogu izazvati asfiksiju. Prikazaćemo slučaj odojčeta koje je imalo rekurentne aspiracione pneumonije i  inspiratorni stridor prozrokovan cistom baze jezika udružen sa gastroezofagealnim refluksom. Prikaz slučaja: Žensko odojče uzrasta dva i po meseca primljeno je u Institut zbog povraćanja, nenapredovanja, hroničnog kašlja, ataka cijanoze i inspiratornog stridora. U kliničkom nalazu prisutni uvlačenje juguluma, stridor, ranoinspiratorni pukoti i nenapredovanje u telesnoj masi(<3.percentila).Na RTG snimku verifikovana aspiraciona pneumonija i bronhitis, na UZ abdomena gastroezofagealni refluks. U okviru šire dijagnostike načinjen CT vrata i grudnog koša, uočena cista na bazi jezika,neposredno  iznad epiglotisa. Urađena laringoskopija i bronhoskopija, verifikovana cista  ispred ulaza u larinks. Konsultovan maksilofacijalni hirurg, te je cista operativnim putem otklonjena. Zaključak: Ciste baze jezika zbog svoje specifične pozicije na raskršću disajnih i digestivnih puteva daju kompleksnu kliničku sliku. Vizuelizacione metode potvrđuju njhovo prisustvo, a najbolji ishod nastaje otklanjanjem istih operativnim putem.

 

 

 

Ključne reči:

inspiratorni stridor,  nenapredovanje u telesnoj masi, aspiraciona pneumonija, kongenitalna cista baze jezika, odojče

 

 

Abstract

 

Introduction: Stridor in neonates and infants is the indicator of upper airway obstruction. Congenital base cysts are uncommon and due to their compressive effect could cause asphyxia. We are presenting a case of an infant with recurrent aspiration pneumonia and stridor  caused by a cyst in conjunction with gastroesophageal  reflux. Case report: A two and a half month old female infant was admitted to the Institute due to vomiting,  stridor, chronic cough, failure to thrive and cyanotic attacks. Clinical findings showed the retraction of jugulum , early inspiratory crackles and failure to thrive (< 3 percentiles ). Chest X ray confirmed  aspiration pneumonia and bronchitis. Ultrasound of abdomen showed gastroesophageal reflux. CT neck images showed a cystic formation at the base of the tongue. Laryngoscopy and bronchoscopy   confirmed the presence of the cyst. With the consent of the maxillofacial surgeon the cyst was removed surgically. Discussion: The potential causes of stridor, aspiration pneumonia and failure to thrive are numerous. The thorough  differential analysis of all the relevant factors  is crucial. In this case the most important techniques in  recognizing  and solving  the problem  were laryngoscopy and the CT scans of the neck. Gastroesophageal  reflux itself can sometimes  cause symptoms similar to stridor , pneumonia and failure to thrive. In  the infant it was present along with the congenital base cyst. Conclusion : Tongue base cysts show a complex clinical status because of their specific position at the crossroads of airways an digestive system. Visual methods confirm their presence, while the best method is their surgical removal.

 

Key words:

inspiratory stridor, failure to thrive,  aspiration pneumonia, congenital tongue base cyst, infant

 

 

 

References:

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PDF Bajić D. et al • MD-Medical Data 2019;11(3-4): 177-180

 

 

 

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