Endotracheal tuberculous stenosis: ventilation rescue and bronchography guided stenting.
We present the case of a 16-year-old female patient who presented with dyspnoea, cough and noisy breathing that progressed further in hospital with the development of stridor and severe respiratory compromise requiring mechanical ventilatory support. Investigations were consistent with a diagnosis of endotracheal tuberculosis with tracheal and bronchial stenosis. Despite adequate anti-tuberculous therapy and ventilation the patient had high airway pressures, low tidal volumes and hypercapnia, which prevented weaning from mechanical ventilation. Balloon dilatation and stenting of the 4.5cm long, 2.3mm diameter stenotic tracheal segment was performed under radiological guidance. The patient was weaned successfully from the ventilator post-procedure. This report illustrates the successful management of an uncommon presentation of a common disease with modern endoscopic therapy.
Ramya
I
I
Department of Medicine and Geriatrics, Christian Medical College and Hospital, Vellore, India. iramya@gmail.com
Mathews
K P
KP
Pichamuthu
K
K
Keshava
Shyamkumar N
SN
Balamugesh
T
T
Ramamani
M
M
Surekha
V
V
Mammen
T
T
D000293:Adolescent; D001982:Bronchial Diseases / Q000209:etiology / Q000628:therapy; D001995:Bronchography; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000628:therapy*; D012121:Respiration, Artificial; D015607:Stents; D014133:Tracheal Diseases / Q000150:complications; D014135:Tracheal Stenosis / Q000209:etiology / Q000628:therapy*; D014376:Tuberculosis / Q000150:complications*