ISSN:1070-8030    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:1070-8030    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The purpose of this study was to demonstrate the existing correlation between bronchoscopic examination and helieal computed tomography with three-dimensional reconstructions. Eighteen patients with non-small cell carcinoma of the lung were studied. A good correlation was observed in patients with stenosis of stem and lobar bronchi, either intrinsic or extrinsic. The three-dimensional images reveal the spatial location of the tumoral mass, the alterations of intrathoracic structures, and the lung parenchyma secondary to tumoral growth. The internal and external views of the bronchial tree also correlate well with the bronchoscopic findings and permit visualizations of the airway changes beyond the stricture. In some patients, this information permits better planning of laser therapy and a better understanding of the actual pathology of the neoplastic process. However, the staging and diagnosis of the patients are not substantially modified.

ISSN:1070-8030    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Between January 1987 and May 1997, hospital records of 980 children (587 boys and 393 girls) ≤15 years old referred to our clinic for suspected airway foreign body aspiration were reviewed. Rigid bronchoscopy was performed for all patients. Foreign bodies were successfully removed in 918 (93.7%) patients; 740 (75.5%) presented with a definite history of foreign body aspiration and 178 (18.2%) did not. In 62 patients (6.3%), bronchoscopy was negative. Watermelon seeds, found in 364 (39%) patients, were the most common foreign bodies. The average length of hospital stay for those who were admitted within 24 hours of the aspiration was < 1 day (20 hours); however, for those who admitted >24 hours after the aspiration event, average length of stay was 3.1 days (p < 0.001). Open surgical procedures were required for 17 (1.7%) patients; tracheostomy through the ventilating bronchoscope for 5, lobectomy for 2, and bronchotomy for 10. Bronchial rupture related to bronchoscopy occurred in 3 patients; 2 died postoperatively. The overall mortality rate was 0.8%. We conclude that parental education is mandatory for decreasing the incidence of airway foreign body aspirations. Our negative bronchoscopy rate (6.3%) is not high compared to other reports and even higher rates may be needed to prevent missed foreign body aspiration and its consequent complications. Expert anesthesia is essential and bronchoscopy should be performed by an experienced staff, if a lower incidence of complications and better results are to be expected.

ISSN:1070-8030    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Between 1991 and 1995, 5.520 rigid bronchoscopies were performed in children al the Bronchologic-Pulmonan Lab of our Institute; a Iracheal bronchus was incidentally found in 21 patients (0.98%). Their ages at the time of bronchoscopy ranged from 3 months to 14.5 years. Indications for bronchoscopy were: recurrent bronchitis not responding to conventional therapy with or without wheeze; unexplained cough; stridor; and recurrent pneumonia. Tracheal bronchus was found in the lower third of the trachea in the majority of patients Tracheal duplication of the right upper lobe (A-type). supernumerary tracheal bronchus (B-type). and tracheal transposition of the right upper lohe (E-type) were described in 8, 10, and 3 patients, respectively. Surgical resection of the tracheal bronchus was not considered necessary in any of the patients. Concomitant airway malformations included dynamic collapse of the trachea as a consequence of cartilage hypoplasia (traeheomalacia) in 3, rigid stenosis in 2, and dynamic collapse of the left main hronchus as a consequence of cartilage hypoplasia in 7 patients; stenosis of ring cartilage, stenosis of truncus intermedius. and stenosis of left lower lobe bronchus in respective cases. Extrapulmonary malformations included congenital heart disease, situs inversus solilus, dextrocardia, diaphragmatic hernia, and pectus excavatum in respective cases. We concluded that tracheal bronchus is regularly but not frequently found in the patients with chronic chest symptoms, that surgical resection of a tracheal bronchus is unnecessary if there is no local pathologic process in the adjacent lung tissue, and that significant associated pulmonary and extrapulmonary developmental disorders are likely with tracheal bronchus.

ISSN:1070-8030    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Pulmonary hypertension (PH) is reported to he a contraindication to bronchoscopic lung biopsy (BLB) because of the risk of uncontrolled hemorrhage. A prospective double-blinded study was designed to determine this risk in 50 patients with interstitial lung disease (ILD) with no clinical or radio-graphic evidence of PH who underwent BLB at Brooke Army Medical Center, a 450-bed teaching hospital. Before BLB. patients undentent Doppler flow echocardiography to determine pulmonary artery (PA) pressures and the size of the right atrium and right ventricle PH was defined as a systolic PA pressure >30 mmHg or evidence of right-sided chamber enlargement if no PA pressure could be determined. Overt bleeding during BLB was measured and additional blood loss was quantitated by comparing the hematocnts of the bronchial washings and the peripheral blood. Blood loss (in mL) was defined as: minimal. ≤10: mild. 11–25; moderate. 26–50; and severe. >50. Twenty-eight patients had no echocardiographic evidence of PH; only I had mild hemorrhage Twenty-two patients had evidence of PH; I patient had moderate hemorrhage. There was no significant difference (p = 0.9) in bleeding between the two groups; patients with PH had a mean blood loss of 2.0 ± 6.2 mL and patients without PH had a mean blood loss of 1.8 ± 3.8 mL. These data reveal that latent PH was present in 44% of our patients undergoing BLB for ILD but there was no increase in bleeding complications in this group.

ISSN:1070-8030    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

A patient with suspected aspiration is described. Chest roentgenogram revealed a mucus plug with an inflated lung and unilateral absence of ventilation and perfusion. which was restored alter bronchoscopy.

ISSN:1070-8030    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Two cases of inadvertent retroflexion of a flexible bronchoscope that occurred while wedging the tip of the bronchoscope into a bronchus of the right upper lobe are described. The bronchoscope acutely turned upward in the left main bronchus in the first patient and in the right main bronchus in the second. To correct this problem, the tip of the bronchoscope was inserted into the opposite main bronchus, and the bronchoscope was gently pulled while the curvature of the flexed portion was simultaneously observed with fluoroscopy. Retro-flexion was safely corrected with this method without removal of the bronchoscope in both patients.

ISSN:1070-8030    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Tracheobronchopathia Osteochondroplastica is a rare disease characterized by metaplastic proliferation of osseus tissue in the anterolateral portion of trachea and bronchi, often concomitant to chronic inflammation of the respiratory tract. Before the advent of bronchoscopy and imaging techniques, it was usually diagnosed at autopsy, and its origin is unknown. A 31-year-old nonsmoking woman with tracheobronchopathia Osteochondroplastica and anomalies of the nose, paranasal sinuses, and falx cerebri is described. A congenital predisposition to hyperplastic-metaplastic changes in the connective tissue on dysontogenetic basis is suggested.

ISSN:1070-8030    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

A 27-year-old woman had tracheal laceration caused by endotracheal intubation by bronehoscopy. She underwent bronchoalveolar lavage and bronchoscopic lung biopsy for suspected sarcoidosis. Endotracheal intubation was performed under bronchoscopic guidance without any difficulty, but, after intubation, tracheal laceration (approximately 3 cm in length) was observed. She was treated conservatively and the laceration healed spontaneously. Though tracheal lacerations are rare, it is necessary to be familiar with such severe complications.

ISSN:1070-8030    

出版商:OVID    

年代:1998

数据来源: OVID