523 Not All Who Wheeze Have Asthma—Tracheal Diverticulum with Stenosis of Trachea in 9 Years Old Boy

BACKGROUND: A tracheal diverticulum (TD) is very rare congenital malformation. The prevalence is about 0.3% in children over 10 years of age according to fiberoptic bronchoscope studies and it is rarely reported in clinical practice (3). Here we describe our recent exprience in succesfully diagnosing and treating a 9-years old box suffering from membranous stenosis of trachey with trachea diverticulum. METHODS: A 9-year old boy (personal history negative as to trauma of respiratory tract and intubation and atopy) was admitted to hospital with wheezing and progressive dyspnoe during the 6 months to restrict basic locomotion and reading of text. Multislice computed tomography of the chest showed surprising incidental finding of a tracheal diverticulum (6 mm × 2 mm) and 3-dimensional reconstruction CT stenosis of trachea approximetly 1,5 cm below vocal corde and orificium of tracheal diverticulum (the 2nd cartilage of trachea). Pulmonary function tests revealed reduction of spirometric values, with no post-bronchodilator change. Subsequent flexible bronchoscopy showed circular stenosis of trachea and orificium of TD. Subsequently, the vaporization by NdYAG laser - Sharplan 3000, with energy of 30 W was performed via flexible bronchoscopy under general anesthesia with a laryngeal mask. The dilatation by balloon (Boston Scientific) was performed to widen the diameter of trachea up to 8 mm. RESULTS: After 1 week, pulmonary function test revealed normal parameters without pathological symptoms. CONCLUSIONS: In conclusion, we have summarized the case of an 9-year old boy with membranous stenosis of trachey and trachea diverticulum, a very rare congenital anomaly. This abnormality can be clearly diasgnosed by multislice CT and 3-dimensional reconstruction CT stenosis of trachea. Using the interventional bronchoscopy of membranous circular stenosis of trachea is adequate solution in children too.