VASCULAR COMPRESSION OF THE TRACHEA PRESE NTING AS BRONCHIOLITIS IN INFANTS

Background. - Anomalies of the aortic arch and pulmonary arteries may produce compression of the trachea with chronic strider or wheezing ag gravated by crying, feeding and flexion of the neck. Case reports. - T hree infants, 3, 5 and 2 months-old, respectively, were admitted suffe ring from acute bronchiolitis. The first patient had intermittent whee zing for one month; lateral chest X-rays showed an opaque area inserte d between the trachea and oesophagus and computed tomography showed pu lmonary artery sling with tracheal stenosis which was successfully ope rated. The second patient displayed pulmonary atelectasia which requir ed bronchoscopy; this technique showed tracheal stenosis which was due to pulmonary artery sling. The third patient had a history of congeni tal stridor: he required endotracheal intubation; a bronchoscopy perfo rmed because persistent pulmonary atelectasia showed tracheal stenosis which was secondary to a double aortic arch. The condition was improv eed after surgical correction. Conclusions. - A history of strider and /or wheezing in patients admitted for bronchiolitis must lead to consi der the possibility of vascular compression of the trachea and to perf orm specific investigations.