Dr.Shobika,Dr.Naveen,Dr.Praveena,Dr.Preethi DrC Jayakumar
Department of pediatrics
AIMS KOCHI
Ten year old boy presented of breathing difficulty for 3 days
No h/o fever,fast breathing,loose stools,chest pain,cough,rashes or Genito urinary symptoms
Past history:
No previous hospital admissions
On examination,child was conscious,oriented
Vitals:stable
S/E:Respiratory system – Air entry bilaterally equal
Other systems within normal limits
Investigations :
TLC-11.82,N-50.3,L-36.5,PCV-38.1
X ray chest : Normal
CT chest – esophageal cyst
Barium swallow – indentation of lower esophagus with no communication
Diagnosis of esophageal duplication cyst is made
The child was taken up for thoracoscopy and deroofing of cyst was done.
Intra operative findings showed a cystic lesion encased smooth muscle fibers in close proximity to distal esophagus on the left side,white serous fluid drained from the lesion,lesion excised in whole,esophageal integrity confirmed instilling air via NG tube. ICD placed and fixed.
Intraoperative and postoperative periods were uneventful.
ICD removed on post op day 5.
Child is being discharged with stable vitals.
Oseophageal cyst:
Are true congenital cysts
most common in middle mediastinum
Bronchogenic cysts are most common (40%–50%), followed esophageal duplication cysts.
Symptoms :
Persistent cough,dyspnea and stridor
Coughing with or without blood, shortness of breath and hoarseness.
Night sweats, chills or fever.
Wheezing or a high-pitched breathing noise.
Unexplained weight loss and anemia.
Swollen or tender lymph nodes.
Diagnosis:CT chest
MRI
PET CT
Stagging:
Stage IIA: Cancer growing into the capsule.
Stage IIB: Cancer growing beyond the capsule into surrounding tissue.
Stage III: Cancer growing into near organs and tissues, including the sac surrounding the heart, the lungs, and the main blood vessels leading into and out of the heart
Management:
Surgical approach – Cyst excision