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Images in Thorax
Micro-CT of tracheal stenosis in trisomy 21
  1. Susan C Shelmerdine1,
  2. Michael T Ashworth2,
  3. Alistair D Calder1,
  4. Nagarajan Muthialu3,
  5. Owen J Arthurs1
  1. 1 Department of Clinical Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  2. 2 Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  3. 3 Department of Cardiothoracic Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  1. Correspondence to Dr Susan C Shelmerdine, Department of Clinical Radiology, Great Ormond Street Hospital for Children, London WC1N 3JH, UK; susan.shelmerdine{at}gosh.nhs.uk

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A male infant with trisomy 21, born at 36 weeks' gestation, had care withdrawn at 2 months of age and was referred for postmortem investigations. The child had been ventilator dependent since the first week of life following surgery for intestinal perforation from necrotising enterocolitis. A CT thorax at 1 month of age demonstrated a tight tracheal stenosis, inferior to the tip of the endotracheal tube, with a luminal diameter of 1.2 mm over a length of 1 cm (figure 1). There were no associated cardiovascular or bronchial tree anomalies. Despite efforts to optimise the child’s condition for tracheal reconstruction, he was subsequently found to have an underlying immune deficit disorder with profound lymphopenia and continued to require iontropic support for haemodynamic compromise. After a further month of expectant clinical management without improvement, care was withdrawn.

Figure 1

Antemortem CT thorax obtained 1 month prior to death. (A) A coronal 5 mm minimum intensity projection (miniP) image, viewed on lung windows, demonstrates the tight tracheal stenosis immediately distal to the endotracheal tube (red square bracket). Axial CT sections obtained (B) above, (C) at the …

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