A case of post-intubation tracheal stenosis mimicking bronchial asthma: case report


Authors: Monika Šatánková 1;  Kristián Brat 1;  Zdeněk Merta 1;  Miloš Šteffl 2
Authors‘ workplace: Klinika nemocí plicních a TBC LF MU a FN Brno, pracoviště Bohunice 1;  Oddělení ORL FN Brno, pracoviště Bohunice 2
Published in: Vnitř Lék 2018; 64(3): 314-320
Category: Case Reports

Overview

Postintubation tracheal stenosis (PITS) is one of the most frequent causes of lower airways obstruction. Usually, PITS is the consequence of prolonged intubation period, but may occur also after short-term intubation. Diagnosis may be difficult if stridor is not present and the post-extubation period is many years long. Bronchoscopy and CT scanning are the diagnostic gold standard. In some cases, lung function tests may also be helpful. Treatment options include conservative treatment, surgery and endoscopic methods. We present a case report of a 23 year old woman with exercise dyspnoea caused by PITS that was incorrectly treated for bronchial asthma during a 2-years long period.

Key words:
bronchoscopy – cardiopulmonary exercise testing – postintubation stenosis – tracheal stenosis


Sources

1. Marel M. Stenózy trachey. Postgrad Med 2006; 8(6): 668–673.

2. Kolek V, Axmann K, Stehlík L. Stenózy velkých dýchacích cest. In: Vašáková M (ed) et al. Bronchologie a pneumologická cytodiagnostika. Maxdorf: Praha 2017: 163–182. ISBN 978–80–7345–533–0.

3. Mihál V, Klásková E, Kopřiva F et al. Opakované respirační infekce jako prezentující příznak zdvojeného aortálního oblouku. Pediatr praxi 2016; 17(2): 117–120.

4. Kolek V. Jiná onemocnění trachey. In: Kolek V, Kašák V, Vašáková M (eds) et al. Pneumologie. 2. vyd. Maxdorf: Praha 2014: 121–125. ISBN 978–80–7345–387–9.

5. D‘Andrilli A, Venuta F, Rendina EA. Subglottic tracheal stenosis. J Thorac Dis 2016; 8(Suppl 2): S140-S147. Dostupné z DOI: <http://dx.doi.org/10.3978/j.issn.2072–1439.2016.02.03>.

6. Murgu SD, Egressy K, Laxmanan B et al. Central Airway Obstruction: Benign Strictures, Tracheobronchomalacia, and Malignancy-related Obstruction. Chest 2016; 150(2): 426–441. Dostupné z DOI: <http://dx.doi.org/10.1016/j.chest.2016.02.001>.

7. Dalar L, Schuurmans MM, Eryuksel E et al. Early tracheal stenosis causing extubation failure and prolonged ventilator dependency. Anaesth Intensive Care 2013; 41(1): 108–112.

8. Su Z, Li S, Zhou Z et al. A canine model of tracheal stenosis induced by cuffed endotracheal intubation. Sci Rep 2017; 7: 45357. Dostupné z DOI: <http://dx.doi.org/10.1038/srep45357>.

9. Corrêa Reis JG, Takiya CM, Lima Carvalho A et al. Myofibroblast persistence and collagen type I accumulation in the human stenotic trachea. Head Neck 2012; 34(9): 1283–1293. Dostupné z DOI: <http://dx.doi.org/10.1002/hed.21915>.

10. Shadmehr MB, Abbasidezfouli A, Farzanegan R et al. The Role of Systemic Steroids in Postintubation Tracheal Stenosis: A Randomized Clinical Trial. Ann Thorac Surg 2017; 103(1): 246–253. Dostupné z DOI: <http://dx.doi.org/10.1016/j.athoracsur.2016.05.063>.

11. Noppen M, Schlesser M, Meysman M et al. Bronchoscopic balloon dilatation in the combined management of postintubation stenosis of the trachea in adults. Chest 1997; 112(4): 1136–1140.

12. Brichet A, Verkindre C, Dupont J et al. Multidisciplinary approach to management of postintubation tracheal stenoses. Eur Respir J 1999; 13(4): 888–893.

13. Dooms C, De Keukeleire T, Janssens A et al. Performance of fully covered self-expanding metallic stents in benign airway strictures. Respiration 2009; 77(4): 420–426. Dostupné z DOI: <http://dx.doi.org/10.1159/000203364>.

14. Noppen M, Piérard D, Meysman M et al. Bacterial colonization of central airways after stenting. Am J Respir Crit Care Med 1999; 160(2): 672–677. Dostupné z DOI: <http://dx.doi.org/10.1164/ajrccm.160.2.9812081>.

15. Stehlik L, Hytych V, Letackova J et al. Biodegradable polydioxanone stents in the treatment of adult patients with tracheal narrowing. BMC Pulm Med 2015; 15: 164. Dostupné z DOI: <http://dx.doi.org/10.1186/s12890–015–0160–6>.

16. Abbasidezfouli A, Shadmehr MB, Arab M et al. Postintubation multisegmental tracheal stenosis: treatment and results. Ann Thorac Surg 2007; 84(1): 211–214. Dostupné z DOI: <http://dx.doi.org/10.1016/j.athoracsur.2007.03.050>.

Labels
Diabetology Endocrinology Internal medicine
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account