PubMed · 2337321
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B J Wiatrak, C M Myer, G O Bratcher. 1990. Mediastinal bronchogenic cyst.. https://doi.org/10.1177/000348949009900516
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PURPOSE: We report the use of an ultrathin fibreoptic bronchoscope (Olympus N20: external diameter: 2.2 mm) as the means of airway endoscopic monitoring during anaesthesia for the excision of mediastinal bronchogenic cysts in two young children. CLINICAL FEATURES: The first, a four-month old boy, presented with stridor and wheezing due to a subcarinal bronchogenic cyst compressing the two main bronchi. The second, an eight-day-old girl whose trachea was intubated, presented with respiratory noise in relation to a bronchogenic cyst compressing the end of the trachea. In both cases, airway endoscopy was performed during anaesthesia with the ultra thin fibreoptic bronchoscope. Endoscopic monitoring allowed, first, a good evaluation of the degree of cyst compression on the airways. Second, the endotracheal tube could be positioned or repositioned with precision in order to avoid severe compression or spilling of liquid into the airways and to allow protection of the suture. Finally, video transmission helped the surgeon to visualize the surgical repair from the inside. CONCLUSION: When added to the classical monitoring using SpO2, PETCO2 and airway pressure, peroperative endoscopic control provides complementary information which can help to detect possible complications more rapidly. This technique could be extended to all airway surgery on very young children.
Bronchogenic cysts are relatively uncommon congenital lesions. Because of the variability in clinical presentation and the shortcomings of diagnostic procedures, bronchogenic cysts present a diagnostic problem. This report describes a giant bronchogenic cyst that presented as a lobar emphysema in a newborn.
We describe the first case of an isolated intra-abdominal esophageal cyst. The cyst was unilocular, smooth-surfaced, and attached to the superior border of the pancreas, and it contained clear mucoid material. The gross and in situ features most closely resemble four previously reported cases of isolated intra-abdominal bronchogenic cyst. Histologically, the cyst contained a simple and pseudostratified, ciliated, mucus-secreting, columnar epithelium and a wall composed of two distinct layers of smooth muscle. Both bronchogenic cysts and esophageal cysts may have ciliated epithelium; however, the presence of two smooth-muscle layers, along with the absence of cartilage or respiratory glands, allows for a definitive diagnosis of esophageal cyst.