López Diana,  Arrate Antonia,  Leal Camilo,  Méndez Daniela,  Pérez-marrero Lizbet

Final Pr. ID: Poster #: CR-043

Case report: Congenital bronchobiliary fistula is a rare congenital malformation, with high morbidity and mortality. It is characterized by a communication between the respiratory and digestive tracts, between a bronchus and the bile duct.
This is a full-term female newborn patient, appropriate for gestational age, who from the third day of life presents with progressive respiratory difficulty associated with abundant waste through a nasogastric tube. She evolved with greater respiratory difficulty, so she was kept on a complete bowel rest and with a nasogastric tube, which increased his output. Airway aspiration was suspected, and an esophagus-stomach-duodenum study was performed to evaluate gastroesophageal reflux, which was normal. The study continued with abdominal ultrasound, showing aerobilia.
The patient evolves with severe respiratory distress and requires mechanical ventilation on day 15, so a chest tomography is performed, which shows aerobilia and a communicating tract between the right main bronchus and the bile duct.
Surgical management was performed with closure of the proximal end of the fistula at the supradiaphragmatic level, without intervening the intrahepatic tract.
The newborn later develops cholestatic syndrome, which is studied with cholangiopancreatography magnetic resonance (MRCP) that reports atresia of the extrahepatic bile ducts, performing an entero-biliary anastomosis in a second surgical procedure.
During her childhood after being discharged, she was diagnosed with several obstructive bronchial syndromes, cholangitis and malnutrition, remaining stable at the outpatient level. She is currently 15 years of age, her only chronic illness being with chronic liver disease, without evidence of clinical or elastographic fibrosis.
Bronchobiliary fistula presents as bronchitis and repeated bronchopneumonia, bilioptysis, cholangitis and sepsis in some cases. Proposed etiologies are either union of an accessory bronchus with an aberrant bile duct or duplication of the foregut. This diagnosis can be associated with other malformations such as bile duct atresia and right diaphragmatic hernia. Computed tomography with 2D and 3D reconstructions and MRCP are recommended for diagnostic workup. Read More

Authors:  López Diana , Arrate Antonia , Leal Camilo , Méndez Daniela , Pérez-marrero Lizbet

Keywords:  Bronchobiliary fistula, Congenital malformation, Bilioptysis

Funaro Kimberly,  Kucera Jennifer

Final Pr. ID: Poster #: EDU-033

Congenital chest lesions encompass a wide array of pathology with overlapping imaging characteristics. With prenatal ultrasound and MRI, more congenital chest lesions are being detected sooner, and it is important for radiologists to be familiar with their imaging findings for both diagnostic and prognostic purposes. This educational exhibit reviews the spectrum of pediatric congenital chest lesions and their key imaging findings.
Read More

Authors:  Funaro Kimberly , Kucera Jennifer

Keywords:  Chest, Congenital malformations

Hirsig Leslie,  Verma Nupur,  Sharma Priya,  Rajderkar Dhanashree

Final Pr. ID: Poster #: EDU-115

Congenital and childhood findings of pulmonary artery anomalies are uncommon but not infrequently encountered by referral centers. We present by case examples anomalies of pulmonary arterial vasculature, and discuss their clinical presentation, associated cardiothoracic anomalies, and overall prognosis. Read More

Authors:  Hirsig Leslie , Verma Nupur , Sharma Priya , Rajderkar Dhanashree

Keywords:  Pulmonary anamolies, Congenital malformations, Pulmonary Origin, Pulmonary Hypertension, Pulmonary complications

Jain Nikshita,  Haider Seemab,  Boag Graham,  Bhandal Samarjeet

Final Pr. ID: Poster #: EDU-019

Anorectal malformations are a fairly common group of congenital anomalies presenting at birth and often as part of a syndrome, with various other associated entities. The purpose of this article is to detail the role of imaging in the evaluation of the anomalies and provide a simple approach to reporting that will provide all the necessary anatomic details to the surgeons for best possible surgical and functional outcome. Read More

Authors:  Jain Nikshita , Haider Seemab , Boag Graham , Bhandal Samarjeet

Keywords:  Anorectal, congenital, malformations

Quintero Pulgarín Daniel,  Rozo Juan,  García Torres Alberto,  Forero Melo Julian,  Acosta Izquierdo Laura

Final Pr. ID: Poster #: CR-047

Pulmonary sequestration is a rare - but well-characterized - congenital malformation of the foregut, the hallmark of the diagnosis consists in the detection of an anomalous systemic arterial supply to a segment of the lung that is isolated from the tracheobronchial tree and therefore nonfunctional, with a pulmonary and/or systemic venous drainage. Depending on the relationship of the abnormal parenchyma with the pleura, it can be classified as intralobar or extralobar.
Nevertheless, the spectrum of congenital lung malformations includes lesions that are predominantly parenchymal, predominantly vascular or hybrid, with variable foregut or airway components intertwined. The exact physiopathological mechanisms for each one of these malformations are yet to be fully understood.
We present a 15-month-old girl with a history of dilated cardiomyopathy. Mild-to-moderate left ventricular (LV) enlargement and a small persistent ductus arteriosus (PDA) were seen on the echocardiogram. The size of the PDA did not explain the LV dilation. An angiography was done to assess the coronary arteries, which were normal. However, it showed an aberrant vessel from the descending aorta to the left lower lobe and severe pulmonary hypertension in the supplied lung, reactive to oxygen. A CT was performed to assess the airway, ruling out the possibility of a pulmonary sequestration and confirming the diagnosis of an isolated major aortopulmonary collateral artery (MAPCA). No evidence of structural heart disease was seen. Unifocalization and ductal ligation were planned.
MAPCA in the absence of an associated congenital heart disease is a rare entity, most seen in preterm babies. The isolated MAPCA tends to regress spontaneously in most cases. However, in a smaller group of patients, it can persist and lead to recurrent respiratory tract infection,
pulmonary hypertension, and lastly heart failure due to left-to-right shunt. Contrast-enhanced computed tomography (CT) is an excellent method for correct identification and treatment guidance.
The purpose of this presentation is to describe an unusual case of our practice, in which the imaging finding of an aberrant arterial supply to the lung is not always related to a pulmonary sequestration, and therefore to draw attention to the fact that in the spectrum of congenital lung
anomalies that are predominantly vascular, isolated MAPCA can be found as the only alteration. Read More

Authors:  Quintero Pulgarín Daniel , Rozo Juan , García Torres Alberto , Forero Melo Julian , Acosta Izquierdo Laura

Keywords:  MAPCA, Congenital malformation, Pulmonary Sequestration