Vascular ring: an important cause of severe upper airway obstruction
- Department of Anaesthesia
- Royal Manchester Children’s Hospital
- Pendlebury
- Manchester M27 4H
Editor—We report three neonates with upper airway obstruction (UAO), who were exposed to acute life threatening events due to a delay in making a correct diagnosis. Chestx-ray, echocardiogram, bronchoscopy and barium swallow were normal or inconclusive. Magnetic resonance imaging (MRI) revealed vascular ring in these cases.
CASE 1
A girl, born at term by caesarean section (3.9 kg birthweight) developed grunting immediately after birth. She was admitted to the special care baby unit with a diagnosis of UAO. Chest x-ray, barium swallow, echocardiogram and bronchoscopy were normal. She was discharged at 10 days of life with persistent stridor without airway compromise or feeding difficulties. She was readmitted eight days later, and was intubated and ventilated for worsening stridor. A chestx-ray revealed bilateral pulmonary oedema. She developed frequent hypoxic episodes and had two cardiopulmonary arrests, both of which were managed successfully. …
