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Congenital high airway obstruction syndrome without tracheoesophageal fistula and with in utero decrease in relative lung size

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Abstract

Congenital high airway obstruction syndrome (CHAOS) is diagnosed by characteristic features on US and MRI including fetal upper airway occlusion, lung hyperinflation with an inverted diaphragm, and sometimes massive ascites and hydrops. We describe a case of CHAOS in which improvement in the fetal condition was observed on three sequential fetal MRIs. Such an improvement was thought to represent decrease in intrathoracic pressure caused by a spontaneous perforation such as a tracheoesophageal fistula. However, a fistula was not observed in the present case. Therefore, we suggest that imaging improvements in patients with CHAOS do not always correspond to the presence of a fistula and other factors might contribute to decreasing fetal intrathoracic pressure.

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References

  1. Lim FY, Crombleholme TM, Hedrick HL et al (2003) Congenital high airway obstruction syndrome: natural history and management. J Pediatr Surg 38:940–945

    Article  PubMed  Google Scholar 

  2. Kuwashima S, Kitajima K, Kaji Y et al (2008) MR imaging appearance of laryngeal atresia (congenital high airway obstruction syndrome): unique course in a fetus. Pediatr Radiol 38:344–347

    Article  PubMed  Google Scholar 

  3. Guimaraes CV, Linam LE, Kline-Fath BM et al (2009) Prenatal MRI findings of fetuses with congenital high airway obstruction sequence. Korean J Radiol 10:129–134

    Article  PubMed  Google Scholar 

  4. Roybal JL, Liechty KW, Hedrick HL et al (2010) Predicting the severity of congenital high airway obstruction syndrome. J Pediatr Surg 45:1633–1639

    Article  PubMed  Google Scholar 

  5. Alvaro RE, Rigatto H (2005) Cardiorespiratory adjustments at birth. In: MacDonald MG (ed) Avery’s neonatology: pathophysiology and management of the newborn, 6th edn. Lippincott Williams & Wilkins, Philadelphia, pp 284–303

    Google Scholar 

  6. Harding R, Hooper SB (1996) Regulation of lung expansion and lung growth before birth. J Appl Physiol 81:209–224

    PubMed  CAS  Google Scholar 

  7. Katz C, Bentur L, Elias N (2011) Clinical implication of lung fluid balance in the perinatal period. J Perinatol 31:230–235

    Article  PubMed  CAS  Google Scholar 

  8. Abraham RJ, Sau A, Maxwell D (2010) A review of the EXIT (EX utero intrapartum treatment) procedure. J Obstet Gynecol 30:1–5

    Article  CAS  Google Scholar 

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Correspondence to Rieko Furukawa.

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Furukawa, R., Aihara, T., Tazuke, Y. et al. Congenital high airway obstruction syndrome without tracheoesophageal fistula and with in utero decrease in relative lung size. Pediatr Radiol 42, 1510–1513 (2012). https://doi.org/10.1007/s00247-012-2446-7

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  • DOI: https://doi.org/10.1007/s00247-012-2446-7

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