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Four Cases of Pulmonary Artery Sling with Bridging Bronchus

Journal of the Korean Pediatric Society 1997;40(5):709-715.
Published online May 15, 1997.
Four Cases of Pulmonary Artery Sling with Bridging Bronchus
Seung A Lee, Jung Yeon Shim, Young Hwue Kim, Jae Kon Ko, In Sook Park, Soo-Jong Hong, Chang Yee Hong
Department of Pediatrics, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
폐동맥 슬링에 동반된 Bridging Bronchus
이승아, 심정연, 김영휘, 고재곤, 박인숙, 홍수종, 홍창의
울산대학교 서울중앙병원 소아과
Pulmonary artery sling with bridging bronchus is not only rare but also difficult to diagnose unless specially sought. When young infant suffers from prolonged or recurrent wheezing, possibility of underlying anomalies of the tracheobronchial trees or great vessels should be considered, even though bronchiolitis and gastroesophageal reflux are the most common causes. We experienced four cases of pulmonary artery sling with bridging bronchus who presented with dyspnea and recurrent wheezing since infancy. Diagnosis was made using bronchoscopy, three dimensional computed tomography, echocardiography and angiography. Bridging bronchus of three patients(case 1, 2, 3) correspond to type IIA and one patient(case 4) to type IIB by Wells classification. Bronchoscopic examinations on 3 patients showed segmental bronchomalacia and near complete obstruction of bronchus by the posterior left pulmonary artery. These congenital bronchial anormalies should be included in differential diagnosis in pediatric patients with unexplained persistent and recurrent wheezing, or emphysema of unknown etiology on plain chest X-ray.
Key Words: Pulmonary artery sling, Bridging bronchus, Bronchoscopy, Three dimensional computed tomography

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