The use of bronchotomy and retrograde dilatation to repair acquired obliterative bronchial obstruction.

A case is presented of acquired obliterative mainstem bronchial obstruction with total ipsilateral lung atelectasis and contralateral lung hyperexpansion. The condition failed to improve after a suitable trial of positive airway pressure and medical management. Penetration of the obstructing lesion bia bronchotomy and a distal retrograde approach successfully opened the airway and the patient has been symptom-free for more than 9 months. This unique approach may be useful in other selected patients with similar acquired lesions.