Paediatric Pulmonology and Allergology

2004 October, Vol. VII, No. 2 (2563-2568)

Congenital vascular dysplasias of the respiratory tract

Gintas Posiūnas, Stanislovas Jonas Maknavicius

The ar­tic­le presnt ori­gi­nal da­ta and per­so­nal ex­pe­rien­ce of the tre­at­ment of con­ge­ni­tal vas­cu­lar dysp­la­sias ba­sed on the Mul­li­ken and Glo­wac­ki clas­si­fi­ca­tion. Con­ge­ni­tal vas­cu­lar dysp­la­sia of the res­pi­ra­to­ry tract is ra­re, but ve­ry se­rio­us pat­ho­lo­gy, which can cau­se com­pli­ca­tions such as tra­che­al obst­ruc­tion, ble­e­ding or in­fec­tion. He­man­gio­ma be­longs to the vas­cu­lar tu­mors group. The­se le­sions are be­nign and cha­rac­te­ri­zed by the ra­pid pro­li­fe­ra­ti­ve pha­se fol­lo­wed by slow spon­ta­ne­ous in­vo­lu­tion. The most com­mon lo­ca­li­za­tion of the he­man­gio­mas is sub­glot­tis. He­man­gio­ma of the res­pi­ra­to­ry tract be­co­mes cli­ni­cal­ly ap­pe­a­red bet­we­en 2 and 4 months of age, when the pro­li­fe­ra­tion is ve­ry fast. Tra­che­os­co­py, CT scan, MRI and co­lo­red dup­lex so­nos­co­py are the met­hods of diag­no­sis. Du­ring the pe­riod of 2000-2004, aut­hors ha­ve diag­no­sed 4 ca­ses of tra­che­al he­man­gio­ma. 3 pa­tients we­re tre­a­ted by the aut­hors, 1 pa­tient was tre­a­ted in Swe­den by the sa­me met­hods. 1 pa­tient un­der­went tra­che­os­to­my be­fo­re the tre­at­ment. All pa­tients we­re tre­a­ted by pri­ma­ry ste­roid the­ra­py. 3 pa­tients re­co­ve­red, 1 pa­tient is still un­der the tre­at­ment, his con­di­tion is im­pro­ving, tra­che­os­to­my al­re­a­dy has be­en re­mo­ved. Vas­cu­lar mal­for­ma­tions are not cha­rac­te­ri­zed by the ra­pid growth, but ne­ver in­vo­lu­te spon­ta­ne­ous­ly. Vas­cu­lar mal­for­ma­tions may in­vol­ve any part of air­way and me­dias­ti­num. Lymp­ha­ti­co-ve­nous mal­for­ma­tion is the most com­mon. Cli­ni­cal­ly ap­pe­a­red could be at any age, usu­al­ly cau­sing the signs of air­way obst­ruc­tion. Tra­che­os­co­py, CT scan, MRI, an­giog­rap­hy and co­lo­red dup­lex so­nog­rap­hy are the diag­nos­tics met­hods. Aut­hors diag­no­sed and tre­a­ted 1 pa­tient with lymp­ha­ti­co-ve­nous mal­for­ma­tion. Pa­tient was ope­ra­ted on and re­co­ve­red. The com­pre­hen­sion of the clas­si­fi­ca­tion, pat­ho­ge­ne­sis and cli­nics of con­ge­ni­tal vas­cu­lar dysp­la­sias is ve­ry im­por­tant in cho­o­sing the met­hods of tre­at­ment.

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