Anomalie encerclante des arcs aortiques; Sousclavière gauche rétro-oesophagienne; Diverticule de Kommerell; Symptômes respiratoires; Dysphagie; Encircling aortic arch anomaly; Retro-esophageal left subclavian artery; Kommerell’s diverticulum; Respiratory symptoms; Dysphagia
Abstract :
[fr] Les anomalies de l’arc aortique, relativement fréquentes,
représentent 15 à 20 % de toutes les maladies cardiovasculaires
congénitales. Elles peuvent être découvertes
face à des symptômes de compression oesophagienne et/ou
des voies respiratoires, tels que dysphagie, toux chronique,
stridor, wheezing, voire infections respiratoires à répétition.
Nous rapportons deux cas d’anomalie encerclante des arcs
aortiques. Le premier patient, âgé de 3 ans, présentait, depuis
l’âge de 4 mois, des symptômes respiratoires avec multiples
épisodes étiquetés de laryngites et d’asthme. Le deuxième, âgé
de 20 mois, présentait un stridor intermittent, de la dysphagie
ainsi que des vomissements fréquents. Chez ces deux patients,
le scanner cervico-thoracique démontra un arc aortique droit
avec une artère sous-clavière gauche rétro-oesophagienne au
départ d’un diverticule de Kommerell. Dans les deux cas, la
cure chirurgicale fut suivie de la disparition des symptômes.
La compréhension du développement embryologique normal
et anormal des arcs aortiques, ainsi que la connaissance des
manifestations cliniques des compressions vasculaires sont
indispensables à leur diagnostic précoce et traitement adéquat. [en] Aortic arch anomalies are relatively frequent and
account for 15 to 20 % of all congenital cardiovascular malformations.
They can be discovered in case of symptoms of
airway- or esophageal compression such as dysphagia, chronic
cough, stridor, wheezing and recurrent respiratory infections.
We report the cases of two children with encircling aortic arch
anomaly. The 3-year-old boy had complained of chronic respiratory
symptoms such as laryngitis and asthma since the
age of 4 months. The 20-month-old boy presented with intermittent
stridor, dysphagia and frequent vomiting. In both
patients, the cervico-thoracic CT-scan showed a right aortic
arch with retro-esophageal left subclavian artery and Kommerell’s
diverticulum. Surgery was curative. The understanding
of normal and abnormal embryologic development of
the aortic arch, and the knowledge of the different types of
vascular compression and their clinical signs are mandatory
for the early diagnosis and adequate treatment of such malformations.
Disciplines :
Cardiovascular & respiratory systems Pediatrics
Author, co-author :
SOLOWIANIUK, Marie ; Centre Hospitalier Universitaire de Liège - CHU > Service de pédiatrie
SOULATGES, C.; CHU Montpellier, France > Cardiopédiatrie
FARHAT, Nesrine ; Centre Hospitalier Universitaire de Liège - CHU > Service de pédiatrie
HOLZKI, Josef ; Centre Hospitalier Universitaire de Liège - CHU > Service de pédiatrie
Seghaye, Marie-Christine ; Université de Liège > Département des sciences cliniques > Pédiatrie cardiologique et pneumologique
Language :
French
Title :
Quand une anomalie encerclante des arcs aortiques se cache derrière des symptômes respiratoires et digestifs de l'enfant
Alternative titles :
[en] When an encircling aortic arch anomaly hides behind respiratory and digestive symptoms in children
Publication date :
2016
Journal title :
Revue Médicale de Liège
ISSN :
0370-629X
eISSN :
2566-1566
Publisher :
Université de Liège. Revue Médicale de Liège, Liège, Belgium
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