To shunt or not to shunt a pulmonary adenomatoid cystic malformation after 33 weeks of gestation: a case report
CONTEXT: Macrocystic adenomatoid malformation of the lung can cause severe mediastinal shift, hydrops and polyhydramnios, thereby increasing the risk of perinatal deaths. After 33 weeks of gestation, repeated puncturing of the cyst is recommended. We present a case in which a cyst-amniotic shunt was...
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| Format: | Article |
| Language: | English |
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Associação Paulista de Medicina
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| Series: | São Paulo Medical Journal |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802008000400011&lng=en&tlng=en |
| _version_ | 1818892102380027904 |
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| author | Rodrigo Ruano Paula Beatriz Tavares Fettback Vinicius Lima Ribeiro Marcus Marques Silva João Gilberto Maksoud Marcelo Zugaib |
| author_facet | Rodrigo Ruano Paula Beatriz Tavares Fettback Vinicius Lima Ribeiro Marcus Marques Silva João Gilberto Maksoud Marcelo Zugaib |
| author_sort | Rodrigo Ruano |
| collection | DOAJ |
| description | CONTEXT: Macrocystic adenomatoid malformation of the lung can cause severe mediastinal shift, hydrops and polyhydramnios, thereby increasing the risk of perinatal deaths. After 33 weeks of gestation, repeated puncturing of the cyst is recommended. We present a case in which a cyst-amniotic shunt was placed instead of performing this procedure. CASE REPORT: A cyst-amniotic shunt was placed at 33 weeks of gestation because of a large macrocystic adenomatoid malformation of the lung associated with severe mediastinal shift and polyhydramnios. Although it was confirmed that the catheter was in the correct place, the cyst increased in size again two weeks later, associated with repetition of polyhydramnios. It was postulated that the catheter was blocked, and we chose to place another catheter instead of performing repeated punctures. The cystic volume, polyhydramnios and mediastinal shift regressed progressively. At 38.5 weeks, a 3,310/g male infant was delivered without presenting any respiratory distress. The infant underwent thoracotomy on the 15th day of life. Thus, in the present study, we discuss the possibility of placing a cyst-amniotic shunt instead of performing repeated cystic punctures, even at a gestational age close to full term. |
| first_indexed | 2024-12-19T17:51:22Z |
| format | Article |
| id | doaj.art-bbb8359628ea4960b1c4e6167a728141 |
| institution | Directory Open Access Journal |
| issn | 1806-9460 |
| language | English |
| last_indexed | 2024-12-19T17:51:22Z |
| publisher | Associação Paulista de Medicina |
| record_format | Article |
| series | São Paulo Medical Journal |
| spelling | doaj.art-bbb8359628ea4960b1c4e6167a7281412022-12-21T20:11:55ZengAssociação Paulista de MedicinaSão Paulo Medical Journal1806-9460126423924110.1590/S1516-31802008000400011S1516-31802008000400011To shunt or not to shunt a pulmonary adenomatoid cystic malformation after 33 weeks of gestation: a case reportRodrigo Ruano0Paula Beatriz Tavares Fettback1Vinicius Lima Ribeiro2Marcus Marques Silva3João Gilberto Maksoud4Marcelo Zugaib5Universidade de São PauloUniversidade de São PauloUniversidade de São PauloUniversidade de São PauloUniversidade de São PauloUniversidade de São PauloCONTEXT: Macrocystic adenomatoid malformation of the lung can cause severe mediastinal shift, hydrops and polyhydramnios, thereby increasing the risk of perinatal deaths. After 33 weeks of gestation, repeated puncturing of the cyst is recommended. We present a case in which a cyst-amniotic shunt was placed instead of performing this procedure. CASE REPORT: A cyst-amniotic shunt was placed at 33 weeks of gestation because of a large macrocystic adenomatoid malformation of the lung associated with severe mediastinal shift and polyhydramnios. Although it was confirmed that the catheter was in the correct place, the cyst increased in size again two weeks later, associated with repetition of polyhydramnios. It was postulated that the catheter was blocked, and we chose to place another catheter instead of performing repeated punctures. The cystic volume, polyhydramnios and mediastinal shift regressed progressively. At 38.5 weeks, a 3,310/g male infant was delivered without presenting any respiratory distress. The infant underwent thoracotomy on the 15th day of life. Thus, in the present study, we discuss the possibility of placing a cyst-amniotic shunt instead of performing repeated cystic punctures, even at a gestational age close to full term.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802008000400011&lng=en&tlng=enCystic adenomatoid malformation of lung, congenitalUltrasonographyPrenatal diagnosisFetal therapyAbnormalities |
| spellingShingle | Rodrigo Ruano Paula Beatriz Tavares Fettback Vinicius Lima Ribeiro Marcus Marques Silva João Gilberto Maksoud Marcelo Zugaib To shunt or not to shunt a pulmonary adenomatoid cystic malformation after 33 weeks of gestation: a case report São Paulo Medical Journal Cystic adenomatoid malformation of lung, congenital Ultrasonography Prenatal diagnosis Fetal therapy Abnormalities |
| title | To shunt or not to shunt a pulmonary adenomatoid cystic malformation after 33 weeks of gestation: a case report |
| title_full | To shunt or not to shunt a pulmonary adenomatoid cystic malformation after 33 weeks of gestation: a case report |
| title_fullStr | To shunt or not to shunt a pulmonary adenomatoid cystic malformation after 33 weeks of gestation: a case report |
| title_full_unstemmed | To shunt or not to shunt a pulmonary adenomatoid cystic malformation after 33 weeks of gestation: a case report |
| title_short | To shunt or not to shunt a pulmonary adenomatoid cystic malformation after 33 weeks of gestation: a case report |
| title_sort | to shunt or not to shunt a pulmonary adenomatoid cystic malformation after 33 weeks of gestation a case report |
| topic | Cystic adenomatoid malformation of lung, congenital Ultrasonography Prenatal diagnosis Fetal therapy Abnormalities |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802008000400011&lng=en&tlng=en |
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