Yenidoğan döneminde nadir bir solunum sıkıntısı nedeni: posterior mediyastinal gastroenterik kist

Abstract

A A r ra ar re e c ca au us se e o of f r re es sp pi ir ra at to or ry y d di is st tr re es ss s i in n t th he e n ne eo on na at ta al l p pe er ri io od d: : p po os st te er ri io or r m me ed di ia as st ti in na al l g ga as st tr ro oe en nt te er ri ic c c cy ys st t E Er rd da al l T Ta afl flk k› ›n n, , K Ke en na an n Ö Öz zc ca an n* *, , M Me eh hm me et t S Sa at ta ar r* *, , N Ne ej ja at t N Na ar rl l› ›* *, , F Fe er rd da a Ö Öz zl lü ü* *, , H Ha ac ce er r Y Ya ap p› ›c c› ›o o¤ ¤l lu u* * IntroductionThe patient was born at term by cesarean section as the fourth living baby from the seventh pregnancy of a preeclamptic mother of 35 years old and a healthy father of 43 years old who had no consanguinity. Apgar score was found to be 5 in the first minute and 8 in the fifth minute. The male baby who had a prediagosis of cystic adenoid malformation in the left lung on ultrasonographical examination performed in the 34 th gestational week prenatally was hospitalized in the Neonatal Intensive Care Unit after birth. Physical examination findings were as follows: birth weight 3400 g (50-75% p), head circumference 35 cm (50-75% p), heigth 49 cm (50-75% p), pulse rate 152/min, blood pressure 78/32 mmHg. Slight prolongation of expirium in the left lung areas compared to the rigth lung areas was found on lung oscultation. Heart sounds were normal, peripheral pulses were palpated simultaneously with heart sounds. No organomegaly was found on abdominal examination and orogastric catheter was inserted into the stomach. Baseline arterial blood gases were as follows: pH: 7.35, PaCO 2 : 43 mmHg, PaO2:71 mmHg, HCO3: 19 mmol/l and oxygen saturation: 95%. Complete blood count and serum biochemical values including sodium, potassium, urea, creatinine, calcium and blood glucose were within normal limits. Right and left paracardial consolidated mass with regular contours was found on thorax graphy and corpus defect was noted in T3, T4 and T5 vertebrae (Picture 1). On thoracic computarized tomography, a large mass lesion pushing the trachea, esophagus and aorta mainly in the right side starting from the upper part of the diaphragm and extending to the upper part of tracheal bifurcation was observed. The cyst was found to be consisted of two parts (Picture 2). On esophagography, 1/3 lower part of the esophagus was dislocated anteriorly and slightly to the left and was compressing the trachea. On echocardiographic examination a cystic formation with dimensions of 3.5x5 cm was found behind the heart adjacent to the left atrium. The patient who had no problem until the 4 th day of life developed respiratory distress on the 4 th day. Blood gases measured simultaneously were as fol- C Ca as se e R Re ep po or rt t S Su um mm ma ar ry yPresentation of mediastinal enteric cysts is observed rarely during neonatal period. They are mostly asymptomatic. The commonest mode of presentation in neonatal period is respiratory distress. Basically, diagnosis of enteric cyst is made with histologic findings. In this article, a cas...