Inhalation depression of ribs and substernal

Introduction The rib and substernal inhalation depression is a clinical manifestation caused by pediatric small jaw deformity syndrome. Micrognathia syndrome (also known as cleft palate - small jaw deformity - hypoglossal syndrome, small mandibular - hypoglossal syndrome, small jaw and big tongue deformity syndrome, inspiratory airway obstruction syndrome, Robin syndrome) Pierre-Robin syndrome. The symptoms are characterized by congenital small jaw deformity, lingual palpebral, cleft palate and inspiratory airway obstruction in neonates and infants. The respiratory tract obstruction caused by this symptom causes death and the incidence is high.

Cause

(1) Causes of the disease

The cause has not been fully elucidated and is associated with a variety of environmental factors, and has recently been shown to be associated with intracellular fetal cell inclusion body virus infection.

(two) pathogenesis

Small jaw deformity is generally thought to occur in the first 4 months of the embryo, caused by interference suppression in the center of the mandibular condyle, and malnutrition during pregnancy, certain drugs during pregnancy, radiation and certain toxin poisoning can be induced All kinds of malformations, including cleft palate and tongue droop triad, Douglas observed that if you can get adequate nutrition after birth, the small jaw deformity can develop to near normal within 6-8 months. Despite this, the true cause of the disease is still unclear and there is no sufficient evidence of genetic factors. It has recently been confirmed that this malformation is associated with intracellular fetal cell inclusion body virus infection. The infection of the virus can occur from the fourth week of pregnancy to the end of pregnancy. The infected mothers are mostly young primiparas. The clinical signs of the mother may not be obvious. The virus infects the fetus through the placenta. The more the infection occurs in the early pregnancy, the more severe the fetus is affected.

an examination

At the time of concurrent infection, peripheral blood leukocyte counts and neutrophils were significantly increased. PaO2 decreased PaCO2 when hypoxemia occurred. According to the clinical selection of X-ray, echocardiography, electrocardiogram and other examinations.

Differential diagnosis

Differential diagnosis of ribs and sub-sternal inhalation depression:

Thoracic collapse deformities are common in funnel chests. The signs of the funnel chest, the sternum (especially the root of the xiphoid) and its corresponding 3rd to 6th costal cartilage are inward, causing the front chest wall to resemble a funnel, and the heart is displaced. One side of the thoracic collapse can be caused by empyema or pleurisy, extensive pleural thickening adhesions and contractions, atelectasis, pulmonary fibrosis, chronic fibrotic tuberculosis, chronic lung suppuration and other diseases.

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