診斷に興味ありし幼兒壓迫性氣管狭窄症例

　緒言

　耳鼻咽喉科領域に於て喘鳴，呼吸困難等の所謂氣道狹窄症状を以て診を乞うものは，其の原因眞に多種多樣であつて，其の確実なる診断を下すに当り，甚だ困難を覚えることがある．我々の許を訪れるものは上氣道に於ける病的障碍が最も多いが，之が慢性に経過したものに於ては急性の場合と異り，喘鳴も呼吸困難も通常比較的軽度であつて其の経過を充分に観察し得るにも不拘，原因探究に際しては異常なる困難に逢着する場合が少くない．

　此処に報告する1例は生後8ケ月の女兒であつて，慢性に経過し喘鳴を伴う軽度の呼吸困難を主訴とし，其のレ線所見が特異であつて種々原因的考察をする上に興味ありと考えられたので，此処に報告し御批判を仰がんとする次第である．

Mishima and Osawa report on a case of bron-chistenosis in a female infant, 8 months old, which was born prematurely. About 4 months previous to the time of examination the infant had pneumonia and, since which it had been affected with marked respiratory wheezing while, of late it is accompanied with slight dyspnea. Roentgen ray picture of the chest reveal a triangular shaped shadow the base of which lying in proximity to the upper portion of the heart and the vertex extending up into the neck. Differential diagnosis on this shadow re-quired consideration of enlarged thymus, tuber-culous fistula and little's disease with difficulty in making a decision among them but, it was finally diagnosed as superior mediastinitis caused by complications of tubercular process. In this condition the symptoms, wheezing and slight dyspnea, might be caused by pressure of the enlarged lymph glands in the mediastinum at the region of bronchial subdivision exerted in sufficient amount to create stenosing effects upon them.