Airway Obstruction as A Fatal Complication of Infantile Hemangioma in Newborns: The Eye Cannot See What the Mind Does Not Know

Xiaoliang Liu¹Ma Li¹Fan Ma¹Jiaojiao Wan¹Huanrui Hu²Kaiyu Zhou³Fan Hu^3*

• ¹West China Children's Medical Center, West China Second University Hospital, Sichuan University, Chengdu, China
• ²West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
• ³Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan Province, China

Background: In newborns, infantile hemangiomas (IHs) involving the airway might rarely present with life-threatening complications associated with airway obstruction without cutaneous haemangioma. Case report: Our female newborn exhibited stridor one day after her birth. Seven days after birth, she was admitted to the local hospital to receive phototherapy for neonatal jaundice. However, her stridor failed to attract the clinician's attention during her local hospitalization. She was transferred to our hospital at 14 days old since her stridor and her condition deteriorated with severe breathlessness and respiratory failure. The computed tomography and flexible bronchoscopy identified obstructive airway IHs. Even though the combination therapy of propranolol and corticosteroids was prescribed for two weeks, she still needed invasive mechanical ventilation. After the multidisciplinary team's discussion, endoscopic resection was carried out to resolve her airway obstruction at 30 days old, but it failed. Finally, the transcatheter interventional sclerotherapy successfully resolved her clinical conditions at 60 days old. She was discharged home and received follow-up with propranolol treatment. Her clinical symptoms of airway IHs completely resolved one year later. Conclusions: Airway IHs might rarely present with life-threatening conditions associated with airway obstruction without cutaneous haemangioma in newborns. It highlights that propranolol is the cornerstone treatment of airway IHs. For the first time, our findings suggested that the transcatheter interventional sclerotherapy might be a strongly additional treatment option.