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Majalah Kedokteran Respirasi

ISSN 0216-5899

Vol. 1 / No. 2 / Published : 2010-07

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Original Article :

Problem diagnostik seorang penderita anak laki-laki dengan large multiple arteriovenous fistula pulmonum dengan multiple abses cerebral

Author :

  1. Sitti Nurisyah*1
  2. Winariani K*2
  3. Soedarsono*3
  1. PPDS I IP Paru FK Unair/RSU Dr. Soetomo Surabaya.
  2. Staf Bag/SMF IP Paru FK Unair/RSU Dr. Soetomo Surabaya
  3. Staf Bag/SMF IP Paru FK Unair/RSU Dr. Soetomo Surabaya

Abstract :

Pulmonary arteriovenous malformation (PAVM) is an uncommon congenital anomaly. PAVM is a direct connection between artery and vein in the pulmonary circulation. PAVM occurs in variety of clinical situations, such as cyanosis, dyspnea, and digital clubbing. Patients with PAVM are having an increasing risk of cerebral abscess. We report the case of a 14 years-old, male patient, who is since 8 years ago, had cyanosis which is difficult to explain using common diagnostic tests. His clinical examination were chest pain, cyanosis, clubbing fingers, and simple partial seizures. Blood gas analysis demonstrated alcalosis respiratory with severe hypoxemia and the initial tests do not detect any cardiac abnormalities. The routine chest radiograph revealed a sharply de­fined lobulated soft tissue mass of uniform density in the right upper hemithorax. He underwent a cerebral CT Scan and was diagnosed to have a multiple cerebral abscesses. The diagnosis was established on the basis of contrast-enhanced computed tomography angiography with three-dimensional images (3D-CT), and the results revealed as detected right pulmonary artery calibre 26mm in size, large multiple pulmonary arteriovenous fistula, small shunting between the right pulmonary artery-proximal aorta descendence, no mass in the right lung, and hepatoportal shunt liver.   Pulmonary arteriovenous fistula is not easily diagnosed with common test, due to its rarity and its unspecific findings on routine examinations. However, this diagnostic hypothesis should always be considered when examining children with cyanosis, in whom the initial tests do not detect cardiac abnormalities. Contrast-enhanced 3D-CT appears to be a reliable noninvasive tool for pretherapy evaluation of PAVM.

Keyword :

Pulmonary arteriovenous malformation , PAVM, Abses serebral,


References :

  1. Friedman BC, McGrath BJ, Williams JF. , (1992). Pulmonary arterio-venous fistula: Mechanical ventilation and hypoxemia. Unknown : Canadian J Anaesthesia


   


Archive Article

Cover Media Content

Volume : 1 / No. : 2 / Pub. : 2010-07
  1. Hubungan pemeriksaan procalcitonin semi-kuantitatif dengan derajat keparahan pneumonia komuniti dan nilai prognostik terhadap outcome penderita
  2. Kemoprevensi pada kanker paru
  3. Manajemen sepsis pada pneumonia
  4. Seorang penderita timoma
  5. Problem diagnostik seorang penderita anak laki-laki dengan large multiple arteriovenous fistula pulmonum dengan multiple abses cerebral