Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgment
- Section 1 Head and neck
- Section 2 Thoracic imaging
- Section 3 Cardiac imaging
- Case 23 Tetralogy of Fallot with pulmonary atresia
- Case 24 Left pulmonary artery sling
- Case 25 Vascular ring
- Case 26 Scimitar syndrome
- Case 27 Portosystemic shunt and portopulmonary syndrome
- Case 28 Aortic coarctation and interrupted aortic arch
- Case 29 Ebstein’s anomaly
- Case 30 Transposition of the great arteries
- Case 31 Total anomalous pulmonary venous return
- Case 32 Aberrant left coronary artery arising from the pulmonary artery
- Section 4 Vascular and interventional
- Section 5 Gastrointestinal imaging
- Section 6 Urinary imaging
- Section 7 Endocrine - reproductive imaging
- Section 8 Fetal imaging
- Section 9 Musculoskeletal imaging
- Index
- References
Case 24 - Left pulmonary artery sling
from Section 3 - Cardiac imaging
Published online by Cambridge University Press: 05 June 2014
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgment
- Section 1 Head and neck
- Section 2 Thoracic imaging
- Section 3 Cardiac imaging
- Case 23 Tetralogy of Fallot with pulmonary atresia
- Case 24 Left pulmonary artery sling
- Case 25 Vascular ring
- Case 26 Scimitar syndrome
- Case 27 Portosystemic shunt and portopulmonary syndrome
- Case 28 Aortic coarctation and interrupted aortic arch
- Case 29 Ebstein’s anomaly
- Case 30 Transposition of the great arteries
- Case 31 Total anomalous pulmonary venous return
- Case 32 Aberrant left coronary artery arising from the pulmonary artery
- Section 4 Vascular and interventional
- Section 5 Gastrointestinal imaging
- Section 6 Urinary imaging
- Section 7 Endocrine - reproductive imaging
- Section 8 Fetal imaging
- Section 9 Musculoskeletal imaging
- Index
- References
Summary
Imaging description
A six-month-old girl was evaluated by her primary care physician for noisy breathing while feeding and failure to thrive. He ordered an upper gastrointestinal study which was normal except for an anterior impression on the mid esophagus (Fig. 24.1a). A chest radiograph (Fig. 24.1b) demonstrated cardiomediastinal shift to the right with a slightly small volume right lung; the lower trachea was poorly visualized. A CT angiogram was then obtained to evaluate for vascular abnormality or mediastinal mass. On the CTA a left pulmonary artery sling (LPAS) was identified as well as a right mid tracheal diverticulum and long segment lower tracheal stenosis with a rounded configuration suggesting complete cartilaginous rings (Fig. 24.1c–e).
Importance
A LPAS occurs when the left postbranchial pulmonary vessels connect with the right instead of the left sixth branchial arch with the aberrant vessel taking a course from right to left between the trachea and esophagus to reach the left hilum (Fig. 24.1c). This course tends to produce an anterior vascular impression on the esophagus (Fig. 24.1a), separating it from the trachea, whereas the anomalous vessels in vascular rings pass posterior to both trachea and esophagus.
- Type
- Chapter
- Information
- Pearls and Pitfalls in Pediatric ImagingVariants and Other Difficult Diagnoses, pp. 98 - 101Publisher: Cambridge University PressPrint publication year: 2014