PDF(Pubmed)
Abstract：
BACKGROUND: Idiopathic subglottic stenosis is a fibrotic condition of unknown origin that results in blockage of the central airway in the subglottic region. It is widely acknowledged that subglottic stenosis is a relatively uncommon structural anomaly that is difficult to operate on and cure due to its anatomical location. Inguinal hernias are well-established to be prevalent in infants and youngsters. We present a case of subglottic stenosis in a child complicated with an inguinal hernia (IH).
METHODS: A 7-year-old female was admitted to our hospital with a 1-month history of progressive bulging in the left lower quadrant of the abdomen. She complained of no stomach discomfort, distension, or dyspnea, but her family reports that the patient usually wheezes during moderate exertion and has no family history of asthma or lung illness. However, for unclear reasons, the infant experienced shortness of breath following training. A chest CT scan was unremarkable. Below the glottis, a membranous stenosis was discovered. The stenosis beneath the glottis was discovered using dynamic laryngoscopy.
METHODS: Idiopathic subglottic stenosis with an IH.
METHODS: An otorhinolaryngologist employed a carbon dioxide laser to eliminate the subglottic stenosis. Following successful intubation by the anesthesiologist, pediatric surgeons performed laparoscopic high ligation of the hernial sac.
RESULTS: After 1 month, a repeat laryngoscopy revealed significant expansion of the subglottic stenosis, accounting for the improvement in respiratory symptoms.
CONCLUSIONS: The present case raises awareness that surgeons should be more vigilant about respiratory complications in patients with an IH. Early diagnosis and treatment of respiratory illnesses are critical for patients undergoing endotracheal intubation.
METHODS: A 7-year-old female was admitted to our hospital with a 1-month history of progressive bulging in the left lower quadrant of the abdomen. She complained of no stomach discomfort, distension, or dyspnea, but her family reports that the patient usually wheezes during moderate exertion and has no family history of asthma or lung illness. However, for unclear reasons, the infant experienced shortness of breath following training. A chest CT scan was unremarkable. Below the glottis, a membranous stenosis was discovered. The stenosis beneath the glottis was discovered using dynamic laryngoscopy.
METHODS: Idiopathic subglottic stenosis with an IH.
METHODS: An otorhinolaryngologist employed a carbon dioxide laser to eliminate the subglottic stenosis. Following successful intubation by the anesthesiologist, pediatric surgeons performed laparoscopic high ligation of the hernial sac.
RESULTS: After 1 month, a repeat laryngoscopy revealed significant expansion of the subglottic stenosis, accounting for the improvement in respiratory symptoms.
CONCLUSIONS: The present case raises awareness that surgeons should be more vigilant about respiratory complications in patients with an IH. Early diagnosis and treatment of respiratory illnesses are critical for patients undergoing endotracheal intubation.
摘要：
背景：特发性声门下狭窄是一种原因不明的纤维化疾病，可导致声门下区域中央气道阻塞。众所周知，声门下狭窄是一种相对罕见的结构异常，由于其解剖位置而难以手术和治愈。腹股沟疝在婴儿和青少年中很普遍。我们介绍了一例并发腹股沟疝（IH）的儿童声门下狭窄的病例。
方法：我院收治一名7岁女性，有1个月的腹部左下腹进行性膨出病史。她抱怨没有胃部不适，扩张，或者呼吸困难,但她的家人报告说，患者通常在适度劳累时喘息，没有哮喘或肺部疾病的家族史。然而,原因不明,婴儿在训练后出现呼吸急促。胸部CT扫描无异常。在声门下面，发现了一个膜性狭窄。使用动态喉镜检查发现声门下方的狭窄。
方法：特发性声门下狭窄伴IH。
方法：耳鼻喉科医师使用二氧化碳激光消除声门下狭窄。麻醉师成功插管后，儿科医生进行腹腔镜疝囊高位结扎术。
结果：1个月后，重复喉镜检查显示声门下狭窄显著扩张，考虑呼吸道症状的改善。
结论：本病例提高了人们的意识，即外科医生应该更加警惕IH患者的呼吸道并发症。呼吸道疾病的早期诊断和治疗对于接受气管插管的患者至关重要。
方法：我院收治一名7岁女性，有1个月的腹部左下腹进行性膨出病史。她抱怨没有胃部不适，扩张，或者呼吸困难,但她的家人报告说，患者通常在适度劳累时喘息，没有哮喘或肺部疾病的家族史。然而,原因不明,婴儿在训练后出现呼吸急促。胸部CT扫描无异常。在声门下面，发现了一个膜性狭窄。使用动态喉镜检查发现声门下方的狭窄。
方法：特发性声门下狭窄伴IH。
方法：耳鼻喉科医师使用二氧化碳激光消除声门下狭窄。麻醉师成功插管后，儿科医生进行腹腔镜疝囊高位结扎术。
结果：1个月后，重复喉镜检查显示声门下狭窄显著扩张，考虑呼吸道症状的改善。
结论：本病例提高了人们的意识，即外科医生应该更加警惕IH患者的呼吸道并发症。呼吸道疾病的早期诊断和治疗对于接受气管插管的患者至关重要。
