Congenital Respiratory Disorders
Congenital respiratory disorders are those disorders or abnormalities, which are present at birth and are usually manifested in the first one year of life. Their incidence is quite low, and hence recognizing and diagnosing these problems is often a challenge, as they are often missed or misdiagnosed. The disorders can be divided into:
- Abnormalities of the thorax
- Abnormalities of the diaphragm (diaphragmatic hernia)
- Abnormalities of the lung like lung sequestration, cystic adenomatoid malformation, Bronchogenic cyst, Foregut cyst
- Abnormalities of blood supply like aberrant vessels, double arch of aorta
- Abnormalities of the airways like tracheal rings, tracheal atresia and tracheomalacia
- Abnormalities of the oral cavity and larynx
What are the key points which point to an unusual diagnosis like congenital respiratory malformations?
In present times, congenital lung abnormalities are being detected much more frequently at routine high-resolution prenatal ultrasonography. Recognizing the antenatal and postnatal ultrasonographic findings of these abnormalities is necessary for optimal prenatal counselling and appropriate management in peri- and postnatal period. If your baby has any of the following symptoms, do consult your pediatric pulmonologist:
- Difficulty in breathing
- Noisy breathing
- Frequent or prolonged chest infections (pneumonia)
- Feeding difficulty
- Frequent regurgitation of feeds
- Wheezing
- Shortness of breath
- Poor weight gain
Diagnosis
Before Delivery:
- Fetal ultrasound
- Fetal echocardiography
- Fetal MRI (magnetic resonance imaging)
After Delivery
- Chest X Ray
- CECT chest (contrast enhanced computed tomography of chest) with or without angiography
- Plain CT computed tomography) chest
- Flexible bronchoscopy
- Swallow studies
- Echocardiography
Treating congenital lung malformations
- FeNO - fractional exhaled nitric oxide
- Blood tests like IgE levels
- Allergy tests
- Radiology in case of doubt of diagnosis
Treatment
The treatment depends upon the diagnosis, site of anomaly and extent of affection. Some of the anomalies require just careful monitoring and supportive care, and may disappear over a period of time like CCAM. Others may require a surgical intervention. However, the bottom line is that these conditions need to be suspected and timely diagnosis and intervention is required for best management of the child.