A Case of VACTERL Association Complicated with Multiple Rib Abnormalities

Zeng Zhiguo; Zhang Guowei; Ji Zhisheng; Yang Yuhao; Yang Hua; Lin Hongsheng

doi:doi:10.11648/j.cnn.20200401.11

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A Case of VACTERL Association Complicated with Multiple Rib Abnormalities

Zeng Zhiguo, Zhang Guowei, Ji Zhisheng, Yang Yuhao, Yang Hua, Lin Hongsheng

Published in Clinical Neurology and Neuroscience (Volume 4, Issue 1)

Received: 17 December 2019 Accepted: 27 December 2019 Published: 4 February 2020

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Abstract

VACTERL association is an acronym that includes vertebral anomalies (V), anal atresia (A), cardiac defects (C), tracheoesophageal fistula (TEF) or esophageal atresia (EA), renal anomalies (R), and limb defects (L). Rib abnormalities have rarely been reported with the VACTERL association. The second case of VACTERL association complicated with multiple rib abnormalities will be reported in this case report. A 4-year-old girl who had been diagnosed with congenital cardiovascular disease and received surgical corrections soon after birth consulted our institution by complaining congenital scoliosis. The little girl was diagnosed with VACTERL association (congenital cardiovascular disease, scoliosis with hemivertebra and butterfly vertebra, and nephrolithiasis) and congenital multiple rib abnormalities. The Cobb angle of the main curve was 29.3° before surgery, 19.9° after surgery, and 23° at last follow-up. Multiple rib abnormalities may be seen in the VACTERL association. Clinicians should have a high index of suspicion when evaluating patients with rib abnormalities associated with VACTERL. It is extremely necessary for careful physical examination and detailed auxiliary examination to each system (including echocardiography, computed tomography, magnetic resonance imaging, and so on) when diagnosing VACTERL association. Also, recognizing and understanding the congenital multiple system malformation is important, which aids in the diagnosis of disease and accordingly plan the therapeutic interventions. Early diagnosis of congenital scoliosis with appropriate surgical intervention decreases long-term morbidity.

Published in	Clinical Neurology and Neuroscience (Volume 4, Issue 1)
DOI	10.11648/j.cnn.20200401.11
Page(s)	1-4
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

VACTERL Association, Rare Diseases, Rib Abnormalities

References

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[2]	Chen Y, Liu Z, Chen J, et al. The genetic landscape and clinical implications of vertebral anomalies in VACTERL association. J Med Genet. 2016. 53: 4317.
[3]	Yang L, Li S, Zhong L, et al. VACTERL association complicated with multiple airway abnormalities: A case report. Medicine 2019, 98 (42): e17413.
[4]	Nezarati M, McLeod D. VACTERL manifestations in two generations of a family. Am J Med Genet. 1999. 82: 402.
[5]	Xu GQ, Zhou QC, Zhang M, et al. TACRD and VACTERL associations in a fetus: case report and review of the literature. Int J Pediatr Otorhinolaryngol. 2013. 77: 20815.
[6]	Behera B, Shaw S, Raj R. Vacterls association with pulmonary arterial hypertension and least vertebral anomaly. YUVA J Med Sci. 2015. 1: 2830.
[7]	Raam MS, Pineda-Alvarez DE, Hadley DW, et al. Long-term outcomes of adults with features of VACTERL association. Eur J Med Genet. 2011. 54: 3441.
[8]	McMaster M. J., Singh H. Natural History of Congenital Kyphosis and Kyphoscoliosis. A Study of One Hundred and Twelve Patients. The Journal of Bone & Joint Surgery. 1999. 81 (10): 1367–1383.
[9]	Ruf M., Harms J. Hemivertebra resection by a posterior approach: innovative operative technique and first results. Spine. 2002. 27 (10): 1116–1123.
[10]	Holte D. C., Winter R. B., Lonstein J. E., Denis F. Excision of hemivertebrae and wedge resection in the treatment of congenital scoliosis. The Journal of Bone & Joint Surgery. 1995. 77 (2): 159–171.
[11]	Jalanko T., Rintala R., Puisto V., Helenius I. Hemivertebra resection for congenital scoliosis in young children: comparison of clinical, radiographic, and health-related quality of life outcomes between the anteroposterior and posterolateral approaches. Spine. 2011. 36 (1): 41–49.
[12]	Yaszay B., O'Brien M., Shufflebarger H. L., et al. Efficacy of hemivertebra resection for congenital scoliosis: a multicenter retrospective comparison of three surgical techniques. Spine. 2011. 36 (24): 2052–2060.
[13]	Erturer, R. E., et al. The Results of Hemivertebra Resection by the Posterior Approach in Children with a Mean Follow-Up of Five Years. Adv Orthop. 2017: 4213413.
[14]	Ruf, M. and J. Harms. Posterior hemivertebra resection with transpedicular instrumentation: early correction in children aged 1 to 6 years. Spine. 2003. 28 (18): 2132-2138.
[15]	Fekete, T. F., et al. Congenital malformations of the growing spine: When should treatment be conservative and when should it be surgical? Orthopade. 2016.45 (6): 518-526.
[16]	Zhu X, Wei X, Chen J, et al. Posterior hemivertebra resection and monosegmental fusion in the treatment of congenital scoliosis. Ann R Coll Surg Engl. 2014. 96 (1): 41–44.

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APA Style

Zeng Zhiguo, Zhang Guowei, Ji Zhisheng, Yang Yuhao, Yang Hua, et al. (2020). A Case of VACTERL Association Complicated with Multiple Rib Abnormalities. Clinical Neurology and Neuroscience, 4(1), 1-4. https://doi.org/10.11648/j.cnn.20200401.11

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ACS Style

Zeng Zhiguo; Zhang Guowei; Ji Zhisheng; Yang Yuhao; Yang Hua, et al. A Case of VACTERL Association Complicated with Multiple Rib Abnormalities. Clin. Neurol. Neurosci. 2020, 4(1), 1-4. doi: 10.11648/j.cnn.20200401.11

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AMA Style

Zeng Zhiguo, Zhang Guowei, Ji Zhisheng, Yang Yuhao, Yang Hua, et al. A Case of VACTERL Association Complicated with Multiple Rib Abnormalities. Clin Neurol Neurosci. 2020;4(1):1-4. doi: 10.11648/j.cnn.20200401.11

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@article{10.11648/j.cnn.20200401.11,
  author = {Zeng Zhiguo and Zhang Guowei and Ji Zhisheng and Yang Yuhao and Yang Hua and Lin Hongsheng},
  title = {A Case of VACTERL Association Complicated with Multiple Rib Abnormalities},
  journal = {Clinical Neurology and Neuroscience},
  volume = {4},
  number = {1},
  pages = {1-4},
  doi = {10.11648/j.cnn.20200401.11},
  url = {https://doi.org/10.11648/j.cnn.20200401.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cnn.20200401.11},
  abstract = {VACTERL association is an acronym that includes vertebral anomalies (V), anal atresia (A), cardiac defects (C), tracheoesophageal fistula (TEF) or esophageal atresia (EA), renal anomalies (R), and limb defects (L). Rib abnormalities have rarely been reported with the VACTERL association. The second case of VACTERL association complicated with multiple rib abnormalities will be reported in this case report. A 4-year-old girl who had been diagnosed with congenital cardiovascular disease and received surgical corrections soon after birth consulted our institution by complaining congenital scoliosis. The little girl was diagnosed with VACTERL association (congenital cardiovascular disease, scoliosis with hemivertebra and butterfly vertebra, and nephrolithiasis) and congenital multiple rib abnormalities. The Cobb angle of the main curve was 29.3° before surgery, 19.9° after surgery, and 23° at last follow-up. Multiple rib abnormalities may be seen in the VACTERL association. Clinicians should have a high index of suspicion when evaluating patients with rib abnormalities associated with VACTERL. It is extremely necessary for careful physical examination and detailed auxiliary examination to each system (including echocardiography, computed tomography, magnetic resonance imaging, and so on) when diagnosing VACTERL association. Also, recognizing and understanding the congenital multiple system malformation is important, which aids in the diagnosis of disease and accordingly plan the therapeutic interventions. Early diagnosis of congenital scoliosis with appropriate surgical intervention decreases long-term morbidity.},
 year = {2020}
}

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TY  - JOUR
T1  - A Case of VACTERL Association Complicated with Multiple Rib Abnormalities
AU  - Zeng Zhiguo
AU  - Zhang Guowei
AU  - Ji Zhisheng
AU  - Yang Yuhao
AU  - Yang Hua
AU  - Lin Hongsheng
Y1  - 2020/02/04
PY  - 2020
N1  - https://doi.org/10.11648/j.cnn.20200401.11
DO  - 10.11648/j.cnn.20200401.11
T2  - Clinical Neurology and Neuroscience
JF  - Clinical Neurology and Neuroscience
JO  - Clinical Neurology and Neuroscience
SP  - 1
EP  - 4
PB  - Science Publishing Group
SN  - 2578-8930
UR  - https://doi.org/10.11648/j.cnn.20200401.11
AB  - VACTERL association is an acronym that includes vertebral anomalies (V), anal atresia (A), cardiac defects (C), tracheoesophageal fistula (TEF) or esophageal atresia (EA), renal anomalies (R), and limb defects (L). Rib abnormalities have rarely been reported with the VACTERL association. The second case of VACTERL association complicated with multiple rib abnormalities will be reported in this case report. A 4-year-old girl who had been diagnosed with congenital cardiovascular disease and received surgical corrections soon after birth consulted our institution by complaining congenital scoliosis. The little girl was diagnosed with VACTERL association (congenital cardiovascular disease, scoliosis with hemivertebra and butterfly vertebra, and nephrolithiasis) and congenital multiple rib abnormalities. The Cobb angle of the main curve was 29.3° before surgery, 19.9° after surgery, and 23° at last follow-up. Multiple rib abnormalities may be seen in the VACTERL association. Clinicians should have a high index of suspicion when evaluating patients with rib abnormalities associated with VACTERL. It is extremely necessary for careful physical examination and detailed auxiliary examination to each system (including echocardiography, computed tomography, magnetic resonance imaging, and so on) when diagnosing VACTERL association. Also, recognizing and understanding the congenital multiple system malformation is important, which aids in the diagnosis of disease and accordingly plan the therapeutic interventions. Early diagnosis of congenital scoliosis with appropriate surgical intervention decreases long-term morbidity.
VL  - 4
IS  - 1
ER  -

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Author Information

Zeng Zhiguo

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Jinan, China
Zhang Guowei

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Jinan, China
Ji Zhisheng

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Jinan, China
Yang Yuhao

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Jinan, China
Yang Hua

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Jinan, China
Lin Hongsheng

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Jinan, China

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Plain Text BibTeX RIS

APA Style

Zeng Zhiguo, Zhang Guowei, Ji Zhisheng, Yang Yuhao, Yang Hua, et al. (2020). A Case of VACTERL Association Complicated with Multiple Rib Abnormalities. Clinical Neurology and Neuroscience, 4(1), 1-4. https://doi.org/10.11648/j.cnn.20200401.11

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ACS Style

Zeng Zhiguo; Zhang Guowei; Ji Zhisheng; Yang Yuhao; Yang Hua, et al. A Case of VACTERL Association Complicated with Multiple Rib Abnormalities. Clin. Neurol. Neurosci. 2020, 4(1), 1-4. doi: 10.11648/j.cnn.20200401.11

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AMA Style

Zeng Zhiguo, Zhang Guowei, Ji Zhisheng, Yang Yuhao, Yang Hua, et al. A Case of VACTERL Association Complicated with Multiple Rib Abnormalities. Clin Neurol Neurosci. 2020;4(1):1-4. doi: 10.11648/j.cnn.20200401.11

Copy | Download

@article{10.11648/j.cnn.20200401.11,
  author = {Zeng Zhiguo and Zhang Guowei and Ji Zhisheng and Yang Yuhao and Yang Hua and Lin Hongsheng},
  title = {A Case of VACTERL Association Complicated with Multiple Rib Abnormalities},
  journal = {Clinical Neurology and Neuroscience},
  volume = {4},
  number = {1},
  pages = {1-4},
  doi = {10.11648/j.cnn.20200401.11},
  url = {https://doi.org/10.11648/j.cnn.20200401.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cnn.20200401.11},
  abstract = {VACTERL association is an acronym that includes vertebral anomalies (V), anal atresia (A), cardiac defects (C), tracheoesophageal fistula (TEF) or esophageal atresia (EA), renal anomalies (R), and limb defects (L). Rib abnormalities have rarely been reported with the VACTERL association. The second case of VACTERL association complicated with multiple rib abnormalities will be reported in this case report. A 4-year-old girl who had been diagnosed with congenital cardiovascular disease and received surgical corrections soon after birth consulted our institution by complaining congenital scoliosis. The little girl was diagnosed with VACTERL association (congenital cardiovascular disease, scoliosis with hemivertebra and butterfly vertebra, and nephrolithiasis) and congenital multiple rib abnormalities. The Cobb angle of the main curve was 29.3° before surgery, 19.9° after surgery, and 23° at last follow-up. Multiple rib abnormalities may be seen in the VACTERL association. Clinicians should have a high index of suspicion when evaluating patients with rib abnormalities associated with VACTERL. It is extremely necessary for careful physical examination and detailed auxiliary examination to each system (including echocardiography, computed tomography, magnetic resonance imaging, and so on) when diagnosing VACTERL association. Also, recognizing and understanding the congenital multiple system malformation is important, which aids in the diagnosis of disease and accordingly plan the therapeutic interventions. Early diagnosis of congenital scoliosis with appropriate surgical intervention decreases long-term morbidity.},
 year = {2020}
}

Copy | Download

TY  - JOUR
T1  - A Case of VACTERL Association Complicated with Multiple Rib Abnormalities
AU  - Zeng Zhiguo
AU  - Zhang Guowei
AU  - Ji Zhisheng
AU  - Yang Yuhao
AU  - Yang Hua
AU  - Lin Hongsheng
Y1  - 2020/02/04
PY  - 2020
N1  - https://doi.org/10.11648/j.cnn.20200401.11
DO  - 10.11648/j.cnn.20200401.11
T2  - Clinical Neurology and Neuroscience
JF  - Clinical Neurology and Neuroscience
JO  - Clinical Neurology and Neuroscience
SP  - 1
EP  - 4
PB  - Science Publishing Group
SN  - 2578-8930
UR  - https://doi.org/10.11648/j.cnn.20200401.11
AB  - VACTERL association is an acronym that includes vertebral anomalies (V), anal atresia (A), cardiac defects (C), tracheoesophageal fistula (TEF) or esophageal atresia (EA), renal anomalies (R), and limb defects (L). Rib abnormalities have rarely been reported with the VACTERL association. The second case of VACTERL association complicated with multiple rib abnormalities will be reported in this case report. A 4-year-old girl who had been diagnosed with congenital cardiovascular disease and received surgical corrections soon after birth consulted our institution by complaining congenital scoliosis. The little girl was diagnosed with VACTERL association (congenital cardiovascular disease, scoliosis with hemivertebra and butterfly vertebra, and nephrolithiasis) and congenital multiple rib abnormalities. The Cobb angle of the main curve was 29.3° before surgery, 19.9° after surgery, and 23° at last follow-up. Multiple rib abnormalities may be seen in the VACTERL association. Clinicians should have a high index of suspicion when evaluating patients with rib abnormalities associated with VACTERL. It is extremely necessary for careful physical examination and detailed auxiliary examination to each system (including echocardiography, computed tomography, magnetic resonance imaging, and so on) when diagnosing VACTERL association. Also, recognizing and understanding the congenital multiple system malformation is important, which aids in the diagnosis of disease and accordingly plan the therapeutic interventions. Early diagnosis of congenital scoliosis with appropriate surgical intervention decreases long-term morbidity.
VL  - 4
IS  - 1
ER  -

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