Airway compression by the ascending aorta due to a thin thoracic cage.
An 89-year-old woman with dyspnea and disturbed consciousness due to hypoventilation was admitted to our hospital. Chest radiography showed no abnormal shadow, but she was intubated for deteriorated hypoventilation. Bronchoscopy demonstrated obstruction of the left main bronchus at the carina. Computed tomography (CT) showed neither a mass lesion in the mediastinum nor an aortic aneurysm, but compression of the airway by the ascending aorta was observed. It was thought that the patient's thin thoracic cage was unable to support the weight of the ascending aorta, which consequently compressed the left main bronchus. After inserting stents into both main bronchi, the patient's consciousness improved, and respirator support was withdrawn. In aged, bedridden, thin patients with hypopnea or recurrent airway infection, CT and bronchoscopy should be performed to investigate airway patency.
Terada
Yasuji
Y
Department of Thoracic Surgery, Nagahama City Hospital, 313 Oinui-cho, Nagahama 526-8580, Japan. yaterada@ex.biwa.ne.jp
Nakayama
Ei
E
Sakaguchi
Yasuto
Y
Kono
Tomoya
T
Noda
Hideki
H
D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D001013:Aorta, Thoracic / Q000002:abnormalities*; D001018:Aortic Diseases / Q000150:complications* / Q000151:congenital; D001980:Bronchi / Q000601:surgery; D001999:Bronchoscopy; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D019919:Prosthesis Implantation; D013902:Radiography, Thoracic; D015607:Stents; D013896:Thoracic Diseases / Q000150:complications* / Q000151:congenital / Q000000981:diagnostic imaging; D013909:Thorax / Q000002:abnormalities*; D014057:Tomography, X-Ray Computed