Silicotuberculosis with oesophagobronchial fistulas and broncholithiasis: a case report.

A 76-year-old woman was admitted to the hospital four times from November 2007 to June 2009. In this complex case, the patient had silicosis complicated by broncholithiasis, oesophagobronchial fistulas, and relapsed tuberculosis. She had worked as a stone crusher for 3 years and was exposed to a large amount of quartz dust. Barium oesophagography, gastroesophageal endoscopy, and biopsy suggested oesophageal-related chronic inflammation and ulceration, which may have caused the repeated oesophagobronchial fistulas. Bronchoscopy revealed a free broncholithiasis in the left mainstem bronchus. The patient was admitted a fourth time because of silicotuberculosis relapse. After 9 months of antituberculosis treatment, the patient recovered and was still clinically well at the time of this writing.

Evaluation of surgical treatments for the major lesion of bilateral silicotuberculosis.

The present communication deals with the follow-up study of 24 patients with bilateral silicotuberculosis in whom only unilateral operation was carried out for major lesions. The operative procedure consisted of pulmonary resection, thoracoplasty or combined operation such as cavernostomy, intracavitary filling of a pedunculated muscle flap and thoracoplasty. The follow-up period ranged 1 year to 12 years and 5 months. The results of surgical treatment for unilateral major lesions and their effect on the contralateral minor lesions were clinically assessed by alterations in the chest x-ray findings and tubercle bacilli in sputum. In 16 of 24 patients (67%) alleviation was obtained, whereas no change occurred in 3 (13%) and aggravation in 5 (21%). The surgical treatment for unilateral major lesion brought about 41% of improvement in the contralateral minor lesions. Contralateral minor lesions remained unchanged in 46% of patients and aggravated in 14%. This shows a value of the surgical threatment for bilateral silicotuberculosis. It should be emphasized that surgical treatments more aggressive than have been heretofore practiced can be employed.

[Clinical and morphological comparisons in pulmonary tuberculosis in workers from pneumoconiosis-risk industries]. / Kliniko-morfologicheskie sopostavleniia pri tuberkuleze legkikh u rabochikh koniozoopasnykh proizvodstv.

The relationship between the efficiency of treatment and the nature of morphological changes in the lung was studied in 125 patients with pulmonary tuberculosis without X-ray signs of pneumoconiosis who worked at coniosis-risk enterprises (CRR). Despite adequate specific and pathogenetic therapy, tuberculomas formed and decay cavities preserved in the patients, in this connection they had surgical treatment. Three types of morphological changes were identified. Quartz-containing industrial dust was found to exert an adverse potentiating effect on the course of tuberculosis in most CRE patients: increases in the delimiting a specific process of respiratory disorders and postoperative complications. These specific features should be borne in mind in drawing up a treatment protocol for patients working exposed to industrial dust.