Airway compression following thymus hyperplasia in an infant with pierre robin sequence and congenital diaphragmatic hernia

A female infant with respiratory embarrassment due to external compression of the tracheobronchial tree by the thymus is presented. After successful i ntrauterine drainage of pleural effusions, she was born with a diaphragmati c hernia and Pierre Robin sequence, which required long-term mechanical ven tilation and several surgical interventions, including tracheostomy, until she breathed spontaneously, At age 7 months, she was rehospitalized in resp iratory failure because of pneumonia, At this time, thymus hyperplasia was first diagnosed, which had caused tracheobronchomalacia and displacement of the tracheobronchial tree. Weaning from the ventilator was unsuccesful for 8 weeks. She underwent thymectomy, following which impairment of breathing resolved immediately. Different manifestations of thymus enlargement and t heir relation to impaired breathing are discussed. (C) 2001 Wiley-Liss, Inc .