Treatment of multiple-level tracheobronchial stenosis secondary to endobronchial tuberculosis using bronchoscopic balloon dilatation with topical mitomycin-C

BMC Pulmonary Medicine

Case Report

Tidi M. Hassan¹  Andrea Y. L. Ban¹  Mohamed Faisal¹  Sanjay H. Chotirmall²  Jamalul Azizi Abdul Rahaman³  Hafaruzi Harun³ 

[1] Department of Medicine, Respiratory Unit, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, 56000, Kuala Lumpur, Cheras, Malaysia;Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore;Respiratory Unit, Serdang Hospital, Jalan Puchong, 43000, Kajang, Selangor Darul Ehsan, Malaysia;

关键词: Case report;    Endobronchial tuberculosis;    Bronchoscopic intervention;    Mitomycin-C;   

DOI  :  10.1186/s12890-016-0209-1

 received in 2016-02-24, accepted in 2016-03-22,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundTracheobronchial stenosis is a known complication of endobronchial tuberculosis. Despite antituberculous and steroid therapy, the development of bronchial stenosis is usually irreversible and requires airway patency to be restored by either bronchoscopic or surgical interventions. We report the use of balloon dilatation and topical mitomycin-C to successful restore airway patency.Case presentationWe present a 24-year old lady with previous pulmonary tuberculosis and laryngeal tuberculosis in 2007 and 2013 respectively who presented with worsening dyspnoea and stridor. She had total left lung collapse with stenosis of both the upper trachea and left main bronchus. She underwent successful bronchoscopic balloon and manual rigid tube dilatation with topical mitomycin-C application over the stenotic tracheal segment. A second bronchoscopic intervention was performed after 20 weeks for the left main bronchus stenosis with serial balloon dilatation and topical mitomycin-C application. These interventions led to significant clinical and radiographic improvements.ConclusionThis case highlights that balloon dilatation and topical mitomycin-C application should be considered in selected patients with tracheobronchial stenosis following endobronchial tuberculosis, avoiding airway stenting and invasive surgical intervention.

【 授权许可】

CC BY   
© Faisal et al. 2016