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Pulmonary artery sling

Case contributed by Hani Makky Al Salam
Diagnosis certain

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

x-ray

Rotated film (look at the pedicle positions compared to the vertebral body). However, despite this, there is still a rightward position of the heart and the NG tube deviates to the right. Slight differential lucency of the lungs. 

ct

CTA clearly demonstrates the aberrant left pulmonary artery arising from the right pulmonary artery passing between the trachea and esophagus.

Coronal reformat demonstrates the main bronchi have a very horizontal course (low T-shaped carina) highly suggestive of tracheal stenosis due to complete cartilage rings—that is, a rigid “O”-ring trachea without a pars membranacea. This is usually associated with high fatality.

Case Discussion

A neonate with pulmonary sling.

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