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1.
BMC Pulm Med ; 19(1): 119, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266473

RESUMO

BACKGROUND: There are few cases of multiple bronchial stenoses reported in the literature and none of the severity described here. The case is relevant due to its rareness, the pathophysiological insights derived, the successful interventional pulmonology strategies demonstrated, and as an example of a rare indication for high-risk lung transplantation. CASE PRESENTATION: A 47-year-old man developed multiple recurrent bronchial web-like stenoses five weeks after an episode of severe tracheo-bronchitis presumed secondary to a chemical inhalation injury which initially caused complete bilateral lung collapse necessitating veno-venous extracorporeal membrane oxygenation. The stenoses completely effaced bronchi in many locations causing severe type II respiratory failure requiring mechanical ventilation and bronchoscopic puncture / dilatation then ultimately bilateral lung transplantation. CONCLUSION: This very rare case highlights the morbid sequelae that can arise after catastrophic tracheobronchitis which now, in the era of extracorporeal membrane oxygenation, may be survivable in the short-term.


Assuntos
Broncopatias/diagnóstico , Constrição Patológica/diagnóstico por imagem , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/terapia , Traqueia/patologia , Broncopatias/induzido quimicamente , Broncoscopia , Queimaduras Químicas/complicações , Queimaduras por Inalação/complicações , Oxigenação por Membrana Extracorpórea , Humanos , Transplante de Pulmão , Masculino , Pessoa de Meia-Idade , Radiografia Torácica , Respiração Artificial , Tomografia Computadorizada por Raios X
2.
Autoimmun Rev ; 18(9): 102353, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31323366

RESUMO

Recent studies show that relapsing polychondritis patients with tracheobronchial involvement are distinct from others in terms of clinical characteristics, therapeutic management, and disease evolution. Tracheobronchial involvement affects 20 to 50% of patients and may reveal the disease. It should be sought at the time of diagnosis and at each follow-up visit. Respiratory impairment is confirmed by computed tomography (CT) of the chest, including the cervical portion of the trachea, with end-inspiratory and dynamic expiratory scans, and pulmonary function tests. These investigations should be performed, even in asymptomatic patients, at the time of diagnosis, and repeated as necessary during follow-up. Bronchoscopy and a fortiori endoscopic intervention should be considered with caution and performed only by expert endoscopists after careful evaluation of the risks and benefits of such procedures, which can lead to damage or perforation of the airways and bronchospasm. Early detection and management of tracheobronchial involvement in relapsing polychondritis has significantly improved the prognosis of patients, especially with the development of interventional fiberoptic bronchoscopy. However, relapsing polychondritis-related morbidity and mortality are still elevated, particularly in tracheobronchial disease.


Assuntos
Broncopatias/etiologia , Policondrite Recidivante/complicações , Doenças da Traqueia/etiologia , Broncopatias/diagnóstico , Broncopatias/mortalidade , Broncopatias/terapia , Broncoscopia/métodos , Diagnóstico Diferencial , Diagnóstico Precoce , Intervenção Médica Precoce/métodos , Humanos , Policondrite Recidivante/diagnóstico , Policondrite Recidivante/mortalidade , Policondrite Recidivante/terapia , Prognóstico , Sistema Respiratório/fisiopatologia , Análise de Sobrevida , Tomografia Computadorizada por Raios X , Doenças da Traqueia/diagnóstico , Doenças da Traqueia/mortalidade , Doenças da Traqueia/terapia
3.
BMC Pulm Med ; 19(1): 104, 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170962

RESUMO

BACKGROUND: Bronchial Dieulafoy's disease (BDD) is a rare disease that is known to be a cause of hemorrhage. The characteristics of this disease are still unknown. The present study describes the disorder based on a review of the world's literature, emphasizing the diagnostic and therapeutic views. METHODS: A comprehensive research of BDD of the PubMed, Google Scholar, and Web of Science databases was performed. The following data were collected: patient characteristics; chest imaging, bronchoscopy, vascular angiography, and histopathologic examination findings; and treatment rendered. RESULTS: 73 cases of BDD have been reported from 1995 to 2019. Most of the cases occurred in Asia (52.1%), followed by Europe (31.5%). Chest imaging findings were non-specific. The main bronchoscopy finding was a nodular or protruding lesion (60.9%). 19 patients underwent bronchoscopic biopsies, 17 had bleeding, and 6 died. Four patients were successfully shown to have vascular malformations under mucosal protrusion by endobronchial ultrasound scan (EBUS). Vascular angiography mainly showed tortuous, dilated bronchial arteries. Vascular angiography mainly showed tortuous, dilated bronchial arteries. The arterial supply was mainly provided by bronchial arteries (48 cases) and the pulmonary circulation (4 cases). The lesions were mainly located in the right bronchus (53 cases). Selective bronchial artery embolization (BAE) was attempted in 38 patients and 20 patients underwent lobectomies. Emergency resection was performed in 15 patients, all of whom survived and had no recurrent hemoptysis. CONCLUSIONS: Massive hemoptysis was the common manifestation of BDD. Vascular angiography and EBUS is a very useful examination before biopsy. BAE may be used in stable patients, or patients who cannot tolerate surgery, while surgical resection should be considered in patients who are unstable, patients with uncontrolled hemoptysis, or following BAE failure.


Assuntos
Brônquios/patologia , Broncopatias/diagnóstico , Hemoptise/diagnóstico , Adulto , Idoso , Angiografia , Broncopatias/cirurgia , Broncoscopia , Embolização Terapêutica , Feminino , Hemoptise/etiologia , Hemoptise/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
5.
Rev Mal Respir ; 36(4): 553-556, 2019 Apr.
Artigo em Francês | MEDLINE | ID: mdl-30853279

RESUMO

Tuberculosis is a disease that is still a too frequent. Its treatment depends on prolonged, multi-antibiotic, chemotherapy. Progress following treatment is generally good but there is the possibility of parenchymatous or pleural sequelae such as bronchial stenosis due to post tuberculous bronchial fibrosis or bronchiolithiasis. On the other hand, bronchial obstruction after treatment by an inflammatory granuloma is rare. It causes wheezing dyspnoea. In this case, relapse of the tuberculosis was feared, possibly with the development of multi-drug resistance. Treatment with corticosteroids allowed a rapid improvement.


Assuntos
Antituberculosos/uso terapêutico , Broncopatias/diagnóstico , Granuloma/diagnóstico , Tuberculose Pulmonar/tratamento farmacológico , Adulto , Broncopatias/patologia , Constrição Patológica/diagnóstico , Constrição Patológica/patologia , Progressão da Doença , Granuloma/patologia , Humanos , Masculino , Radiografia Torácica , Recidiva , Falha de Tratamento , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/patologia
6.
Medicine (Baltimore) ; 98(7): e14471, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30762767

RESUMO

RATIONALE: Dieulafoy's lesions are characterized by the presence of a dysplastic artery in the submucosa, most frequently associated with gastrointestinal hemorrhage. They are rarely identified in the bronchial submucosa and can cause massive or fatal hemoptysis PATIENT CONCERNS:: The patient was a 62-year-old male farmer with intermittent hemoptysis of approximately 2 years duration and a definite diagnosis could not be established. DIAGNOSIS: A thorax-computed tomography at our hospital revealed that the bronchus of left lower lobe was narrowed with associated local atelectasis, and lung cancer was suspected. A bronchoscopy showed a slit-like stenosis of the left lower lobe, swollen and smooth mucosa, and a significantly wider subsection carina. INTERVENTIONS: A fatal hemorrhage occurred during biopsy and, rescue and resuscitation measures were immediately taken. A double-lumen endotracheal intubation was implanted and single-lung ventilation was started to maintain oxygenation. Hemoptysis completely stopped after bronchial artery embolization. OUTCOMES: The patient eventually died of disseminative intravascular coagulation and multiple organ failure. Bronchial arteriography and subsequent autopsy confirmed Dieulafoy's disease of the bronchus. LESSONS: In cases with recurrent unexplained hemoptysis, where CT chest or thoracic radiography show no abnormalities, pulmonologist should suspect a bronchial Dieulafoy's disease and avoid blindly performing bronchoscopy guided biopsy, which may result in fatal hemoptysis.


Assuntos
Brônquios/patologia , Broncopatias/patologia , Doenças Vasculares/patologia , Broncopatias/complicações , Broncopatias/diagnóstico , Hemoptise/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Vasculares/complicações , Doenças Vasculares/diagnóstico
7.
Clin Lab ; 65(1)2019 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-30775886

RESUMO

BACKGROUND: To report a case of broncholithiasis with recurrent hemoptysis and fever initially misdiagnosed as active tuberculosis. METHODS: The chest contrast-enhanced CT scan, electronic bronchoscope, and ultrathin bronchoscope were performed leading to the diagnosis of broncholithiasis, open lung lobectomy was done after thoracic surgery consultation. RESULTS: The chest contrast-enhanced CT scan showed a high-density intratracheal shadow and calcified lymph nodes. Ultrathin bronchoscopy manifested calcified lesions located at the distal portion of the right lower lobe bronchus. Histopathology of lobectomy showed lithiasis in the right lower lobe tracheobronchial tree. CONCLUSIONS: We should pay attention to calcified intratracheal lesions and make differential diagnosis with tuberculosis, especially when accompanied with calcified lymph nodes and fever.


Assuntos
Broncopatias/diagnóstico , Febre/complicações , Hemoptise/complicações , Litíase/diagnóstico , Tuberculose Pulmonar/diagnóstico , Tuberculose/diagnóstico , Adulto , Broncopatias/complicações , Diagnóstico Diferencial , Erros de Diagnóstico , Feminino , Febre/patologia , Hemoptise/patologia , Humanos , Litíase/complicações , Pulmão/diagnóstico por imagem , Pulmão/patologia , Pulmão/cirurgia , Procedimentos Cirúrgicos Pulmonares , Recidiva , Tomografia Computadorizada por Raios X
8.
World J Pediatr Congenit Heart Surg ; 10(1): 111-115, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30799720

RESUMO

Left mainstem bronchial compression by a midline descending thoracic aorta is a rare anatomic variant. Translocation of the descending thoracic aorta to the ascending aorta has recently been described to treat this condition. We performed an aortic translocation and right pulmonary artery reimplantation in a 4-month-old infant with severe pulmonary hypertension secondary to right pulmonary artery stenosis and left bronchial compression by a midline descending thoracic aorta. The procedure was successful in ameliorating the patient's left mainstem bronchial compression and pulmonary hypertension. Descending aortic translocation should be considered when the left bronchus is compressed causing respiratory symptoms.


Assuntos
Aorta/cirurgia , Broncopatias/cirurgia , Constrição Patológica/cirurgia , Artéria Pulmonar/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos , Aorta/anormalidades , Aorta/diagnóstico por imagem , Broncopatias/congênito , Broncopatias/diagnóstico , Constrição Patológica/congênito , Constrição Patológica/diagnóstico , Humanos , Lactente , Masculino , Artéria Pulmonar/anormalidades , Artéria Pulmonar/diagnóstico por imagem , Reimplante , Tomografia Computadorizada por Raios X
9.
Int J Infect Dis ; 80: 80-83, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30639404

RESUMO

BACKGROUND: Endobronchial tuberculosis (EBTB) is a challenging diagnosis because of its varied clinical and radiological manifestations. Hilar asymmetry on chest radiograph (CXR) may be found in patient with EBTB but is often overlooked, which may lead to delayed diagnosis. CASE REPORT: We present five cases with EBTB. Clinicians failed to identify unilateral hilar abnormalities on CXR, and these patients were treated initially for pharyngitis, bronchitis, or pneumonia with no improvement. Subsequently, they visited the pulmonary clinic and bronchoscopy revealed endobronchial lesions and microbial/histopathological evidence of tuberculous infection consistent with EBTB. Anti-tuberculosis therapy resulted in complete clinical resolution in four of the five patients; one patient had persistent bronchial stenosis. CONCLUSION: Hilar asymmetry on CXR may occur with EBTB and may suggest this diagnosis in the appropriate clinical setting. Bronchoscopy has an important role in establishing the final diagnosis.


Assuntos
Broncopatias/diagnóstico , Tuberculose Pulmonar/diagnóstico , Adulto , Idoso , Antituberculosos/uso terapêutico , Broncopatias/tratamento farmacológico , Broncopatias/microbiologia , Lavagem Broncoalveolar , Broncoscopia , Feminino , Humanos , Masculino , Mycobacterium tuberculosis/isolamento & purificação , Índice de Gravidade de Doença , Tuberculose Pulmonar/tratamento farmacológico
11.
Vet Radiol Ultrasound ; 60(2): E20-E23, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28547920

RESUMO

A Staffordshire terrier presented for evaluation of a chronic, nonproductive cough that was unresponsive to antibiotic therapy. A large mass identified in the pulmonary hilum was most consistent with tracheobronchial lymphadenopathy on radiographic and computed tomography (CT) images. Bronchoscopy confirmed a mass compressing the dorsal portion of the intrathoracic trachea. Bronchoscopic biopsies of the tracheal mass revealed necrosuppurative and eosinophilic inflammation with intralesional Pythium insidiousum hyphae. Pythiosis should be included as a differential diagnosis for tracheobronchial lymphadenopathy and bronchopneumopathy in dogs, especially when the patient is from or has visited a region endemic for Pythium insidiosum.


Assuntos
Broncopatias/veterinária , Tosse/veterinária , Doenças do Cão/diagnóstico , Pneumopatias/veterinária , Linfadenopatia/veterinária , Pitiose/diagnóstico , Doenças da Traqueia/veterinária , Animais , Broncopatias/diagnóstico , Broncopatias/diagnóstico por imagem , Broncopatias/microbiologia , Broncoscopia/veterinária , Tosse/diagnóstico por imagem , Diagnóstico Diferencial , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/microbiologia , Cães , Pneumopatias/diagnóstico , Pneumopatias/diagnóstico por imagem , Pneumopatias/microbiologia , Linfadenopatia/diagnóstico , Linfadenopatia/diagnóstico por imagem , Linfadenopatia/microbiologia , Masculino , Pitiose/diagnóstico por imagem , Pitiose/microbiologia , Pythium/fisiologia , Radiografia/veterinária , Tomografia Computadorizada por Raios X/veterinária , Doenças da Traqueia/diagnóstico , Doenças da Traqueia/diagnóstico por imagem , Doenças da Traqueia/microbiologia
12.
Zhonghua Jie He He Hu Xi Za Zhi ; 41(12): 949-953, 2018 Dec 12.
Artigo em Chinês | MEDLINE | ID: mdl-30522192

RESUMO

Objectives: To summarize the computed tomography angiography(CTA) features of Dieulafoy disease of the bronchus. Methods: The clinical, imaging and pathological data of Dieulafoy disease of the bronchus diagnosed in our hospital from July 4, 2010 to June 20, 2016 were retrospectively analyzed, and the CTA imaging features of the abnormal bronchial arteries were summarized. Results: There were 6 cases of bronchial Dieulafoy disease, 5 males and 1 female, with an average age of (55±15) years. Three cases had smoking history, and 2 cases had underlying diseases such as tuberculosis and acute myeloid leukemia. The common manifestations were hemoptysis, fever and pneumonia. Three patients got CTA examination, and bronchial arteries of Dieulafoy disease of the bronchus were circuitous and dilated, with the vascular diameter lager than 2 mm, no gradual narrowing but sudden truncation. Some circuitous vessels went into bronchial lumen as nodules. The bronchoscopy biopsy of 2 cases of bronchial nodules led to severe hemorrhage, with one death and one survival by successful management. Conclusions: Bronchial arteries of Dieulafoy disease of the bronchus were circuitous and dilated, and some circuitous vessels went into bronchial lumen as nodules, this demonstration can be used to diagnose Dieulafoy disease of the bronchus. For patients with hemoptysis, bronchial biopsy should only be performed after CTA examination if this disease is suspected.


Assuntos
Brônquios/diagnóstico por imagem , Artérias Brônquicas/patologia , Broncopatias/diagnóstico , Angiografia por Tomografia Computadorizada , Hemoptise/diagnóstico , Adulto , Idoso , Artérias Brônquicas/diagnóstico por imagem , Broncopatias/complicações , Broncoscopia , Feminino , Hemoptise/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
13.
J Pediatr Surg ; 53(12): 2386-2389, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30244937

RESUMO

PURPOSE: The purpose of this study was to clarify the relationship between congenital pulmonary airway malformation volume ratio (CVR) of bronchial atresia (BA), CVR of congenital cystic adenomatoid malformations (CCAM), and time of surgery after birth. METHOD: We retrospectively analyzed data of 36 BA and CCAM cases, prenatally diagnosed as CPAM from 2009 through 2014. RESULTS: Within 2 h after birth, 12 neonatal patients underwent emergent (EMG) lobectomy. Five cases of lobectomy were performed urgently (UG) from 12 to 48 h after birth. Four cases of lobectomy were required within 30 days after birth (early = EAG). We performed lobectomy in 15 other patients at 11 months after birth (late = LG). Of the EMG cases, 11 were macrotype CCAM (maximal CVR >2.0), and 4 of 5 UG cases were microtype CCAM (CVR >2.0). Of the EAG cases, 3 of 4 were macrotype CCAM with CVR of <1.5. Of 15 LG, 13 were BA and showed a CVR of 0.13-3.0 (median, 0.78). The CVR of the cases operated on within 48 h after birth was significantly larger than that of the cases operated on after 2 weeks (p = 0.001). CONCLUSION: EMG or UG lobectomy was usually required after birth in CCAM, indicating maximal CVR >2.0. By contrast, elective surgery was performed in most BA cases. LEVEL OF EVIDENCE: IV.


Assuntos
Broncopatias/cirurgia , Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia , Pneumonectomia/métodos , Medição de Risco/métodos , Broncopatias/congênito , Broncopatias/diagnóstico , Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico , Tratamento de Emergência/métodos , Humanos , Recém-Nascido , Pneumonectomia/estatística & dados numéricos , Diagnóstico Pré-Natal/métodos , Estudos Retrospectivos , Fatores de Tempo
14.
J Pediatr Surg ; 53(12): 2390-2393, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30227995

RESUMO

BACKGROUND/PURPOSE: Differences in clinical features between congenital pulmonary airway malformation (CPAM) and bronchial atresia (BA) have not yet been clearly described. METHODS: We retrospectively reviewed 112 patients with a pathological diagnosis of CPAM or BA. The clinical parameters were statistically analyzed between these diseases. RESULTS: Seventy-one patients received prenatal diagnosis and 41 received postnatal diagnosis. The percentage of prenatal diagnosis was significantly higher in CPAM patients (84% vs 50%, p < 0.001). Among patients with prenatal diagnosis, the backgrounds were not different between the two diseases except for the number of Caesarean sections (81% vs 9%, p < 0.0001). The numbers of patients that underwent fetal interventions and emergent neonatal surgery were higher in CPAM (51% vs 15%, p < 0.01 and 76% vs 12%, p < 0.0001), although there was no statistical difference in survival rate (86% vs 97%, p = 0.2). In patients receiving postnatal diagnosis, pneumonia was the primary symptom in most BA patients, whereas respiratory distress was the major symptom in patients with CPAM. Age at presentation of the primary symptom was significantly older in BA patients (4.2 years vs 1.2 years, p < 0.005). CONCLUSION: CPAM and BA have distinct clinical features in terms of therapeutic and natural history. Careful imaging evaluation and pathological analysis can lead to an accurate diagnosis of BA. TYPE OF STUDY: Prognostic study. LEVEL OF EVIDENCE: Level II. This study is categorized as a "Prognostic Study" with LEVEL III of Evidence.


Assuntos
Broncopatias/diagnóstico , Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico , Broncopatias/congênito , Broncopatias/terapia , Malformação Adenomatoide Cística Congênita do Pulmão/terapia , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Diagnóstico Pré-Natal/estatística & dados numéricos , Prognóstico , Estudos Retrospectivos
15.
NPJ Prim Care Respir Med ; 28(1): 31, 2018 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-30108224

RESUMO

Exercise-induced bronchoconstriction (EIB) can occur in individuals with and without asthma, and is prevalent among athletes of all levels. In patients with asthma, symptoms of EIB significantly increase the proportion reporting feelings of fearfulness, frustration, isolation, depression and embarrassment compared with those without symptoms. EIB can also prevent patients with asthma from participating in exercise and negatively impact their quality of life. Diagnosis of EIB is based on symptoms and spirometry or bronchial provocation tests; owing to low awareness of EIB and lack of simple, standardised diagnostic methods, under-diagnosis and mis-diagnosis of EIB are common. To improve the rates of diagnosis of EIB in primary care, validated and widely accepted symptom-based questionnaires are needed that can accurately replicate the current diagnostic standards (forced expiratory volume in 1 s reductions observed following exercise or bronchoprovocation challenge) in patients with and without asthma. In patients without asthma, EIB can be managed by various non-pharmacological methods and the use of pre-exercise short-acting ß2-agonists (SABAs). In patients with asthma, EIB is often associated with poor asthma control but can also occur in individuals who have good control when not exercising. Inhaled corticosteroids are recommended when asthma control is suboptimal; however, pre-exercise SABAs are also widely used and are recommended as the first-line therapy. This review describes the burden, key features, diagnosis and current treatment approaches for EIB in patients with and without asthma and serves as a call to action for family physicians to be aware of EIB and consider it as a potential diagnosis.


Assuntos
Broncopatias/etiologia , Exercício , Adolescente , Asma/complicações , Asma/etiologia , Broncopatias/diagnóstico , Broncopatias/epidemiologia , Broncopatias/terapia , Criança , Constrição Patológica , Feminino , Humanos , Masculino
16.
Medicine (Baltimore) ; 97(28): e11464, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29995804

RESUMO

RATONALE: Cicatricial bronchial stenosis or obstruction occurring in the healing process of endobronchial tuberculosis (ET) is a problematic complication of tuberculous airway lesions. Prevention by internal medical treatment is desired. PATIENT CONCERNS: This case series describes four patients who diagnosed ET with Type IIIb (protruding ulcer-type) based on Arai's classification of bronchoscopic findings of bronchial tuberculosis. DIAGNOSES: Endobronchial tuberculosis. INTERVENTIONS: A local steroid spray was applied bronchoscopically to active protruding ulcer-type lesions (which are likely to cause cicatricial stenosis) that extended in the transverse direction and occupied one-half or more of the circumference on bronchoscopy. OUTCOMES: Cicatricial stenosis was prevented in two of four patients. Treatment was discontinued in athird patient because tolerance could not be achieved, although the patient's condition had improved. In the fourth patient, treatment was switched to systemic steroid administration because of a problem with tolerance and the broad range of the lesion; however, stenosis remained. LESSONS: Local steroid spray-applied bronchoscopically to bronchial tuberculosis lesions in the ulcer formation and granulation periods may help prevent stenosis.


Assuntos
Broncopatias/tratamento farmacológico , Broncoscopia/efeitos adversos , Glucocorticoides/administração & dosagem , Tuberculose/complicações , Adulto , Idoso de 80 Anos ou mais , Brônquios/patologia , Broncopatias/diagnóstico , Broncopatias/etiologia , Constrição Patológica/complicações , Constrição Patológica/tratamento farmacológico , Feminino , Humanos , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
17.
Intern Med ; 57(22): 3277-3280, 2018 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-29984759

RESUMO

Blunt airway trauma is rare but life threatening. Injuries to other vital organs accompany this type of injury in most cases; therefore, conservative treatment may be considered first. In cases of delayed fibrotic airway stenosis after conservative treatment, surgical treatment or bronchoscopic intervention are therapeutic options. We herein report a case of delayed airway stenosis after a blunt traumatic airway injury that was successfully managed by silicone stenting.


Assuntos
Brônquios/lesões , Broncopatias/cirurgia , Broncoscopia/métodos , Stents , Traumatismos Torácicos/complicações , Ferimentos não Penetrantes/complicações , Brônquios/diagnóstico por imagem , Brônquios/cirurgia , Broncopatias/diagnóstico , Broncopatias/etiologia , Constrição Patológica/diagnóstico , Constrição Patológica/etiologia , Constrição Patológica/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Traumatismos Torácicos/diagnóstico , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Ferimentos não Penetrantes/diagnóstico , Ferimentos não Penetrantes/cirurgia
18.
Thorac Surg Clin ; 28(3): 365-375, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30054074

RESUMO

Airway complication (AC) after lung transplant, although rare nowadays, leads to increased costs, greater morbidity, and decreased quality of life of patients. Over the years, many risk factors have been described, ranging from surgical technique to immunosuppressive regimen. There are essentially 6 major airway complications (necrosis/dehiscence, infection, bronchial stenosis, granulomas, tracheo-bronchomalacia, and fistula) all of which require a multidisciplinary approach based on the performance status of patients. In this article, the authors review the risk factors, clinical presentation, diagnosis methods, and management options in the most common AC after lung transplantation.


Assuntos
Broncopatias/etiologia , Transplante de Pulmão/efeitos adversos , Complicações Pós-Operatórias , Anastomose Cirúrgica/efeitos adversos , Brônquios/cirurgia , Broncopatias/diagnóstico , Broncopatias/terapia , Broncomalácia/etiologia , Broncoscopia , Constrição Patológica/etiologia , Feminino , Granuloma/etiologia , Humanos , Masculino , Necrose/etiologia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/terapia , Qualidade de Vida , Fístula do Sistema Respiratório/etiologia , Infecções Respiratórias/etiologia , Fatores de Risco
19.
Int J Pediatr Otorhinolaryngol ; 111: 180-182, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29958606

RESUMO

Congenital bronchial stenosis is a rare entity [1,2]. While there are some reports of congenital bronchial anomalies and their repair in the thoracic literature this is first report in the literature of a bronchial take off just below the larynx managed with surgical success. Here we present a case of a former 33-weeker born with a tracheoesophageal fistula, Tetralogy of Fallot, and a high bifurcation of the right mainstem bronchus with a concomitant long segment bronchial stenosis. Preoperative planning included printing 3-D reconstructed models of the airway to analyze various treatment options. At 3 months of age the patient was taken to the operating room for surgical repair of the Tetralogy of Fallot and side-to-side tracheobroncheoplasty. The patient was extubated on postoperative day 3 and was discharged home without need for any ventilatory support.


Assuntos
Anormalidades Múltiplas/cirurgia , Brônquios/cirurgia , Broncopatias/cirurgia , Traqueia/cirurgia , Anormalidades Múltiplas/diagnóstico , Anastomose Cirúrgica , Brônquios/anormalidades , Broncopatias/congênito , Broncopatias/diagnóstico , Constrição Patológica , Humanos , Lactente , Masculino , Tetralogia de Fallot/diagnóstico , Tetralogia de Fallot/cirurgia , Fístula Traqueoesofágica/congênito , Fístula Traqueoesofágica/diagnóstico , Fístula Traqueoesofágica/cirurgia
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