• Title/Summary/Keyword: Tracheal obstruction

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Obstructive Fibrinous Tracheal Pseudomenbrane Mimicking Tracheal Stents

  • Kim, Ju-Sang;Yu, Ji-Hyun;Kim, Yu-Seung;Kim, Il;Ahn, Joong-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.1
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    • pp.59-61
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    • 2011
  • Obstructive Fibrinous Tracheal Pseudomenbrane (OFTP) is a rarely known but potentially fatal complication of endotracheal intubation. Sudden respiratory failure shortly after extubation is not infrequent in the ICU. However, these cases are commonly diagnosed as laryngospasm, retention of secretion or laryngeal edema. A 68-year-old woman presented with a 6-day history of progressive dyspnea. She had undergone invasive ventilator care for 24 hours. The patient was discharged from the hospital with improvement after having an extubation. However, after 3 days she revisited the emergency department with progressive dyspnea. The patient was diagnosed with OFTP from the results of chest CT and bronchoscopy. This is the first case studied in detail using CT images, pulmonary function test, and bronchoscopy.

Results of Segmental Resection and Reconstruction of the Trachea for Obstructive Tracheal Lesions (기관 폐쇄 병변에서 시행된 기관 절제 및 재건술에 대한 결과)

  • 김명천;박주철;조규석;유세영;김범식
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.792-798
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    • 1998
  • Background: There are various tracheal diseseas which cause the obstruction of the trachea: postintubation tracheal stenosis, tracheal cancer, thyroid cancer, endotracheal tuberculosis, et al. Recently surgical resection and reconstruction of the trachea has been adopted as the safe method for tracheal lesions. Materials and methods: We report our experience and results of resection and reconstruction for various obstructive tracheal lesions in 38cases from 1985 to 1996. Length of resection of the trachea was up to 6 cm. Twenty lesions were approached by cervical collar incision, 12 lesions by cervicosternal incision and 4cases needed transthoracic approach. Surgical procedures consisted of resection and tracheotracheal anastomosis in 32 cases, resection and laryngotracheal anastomosis in 6cases and in addition laryngeal release was necessary to release anastomotic tension in 3cases. Results: The complications were 4 minor wound infections, 2 mild suture line granulomas, 1 vocal cord palsy, 2 pneumonias and 1 systemic candidiasis. Two patients who had poor consciousness and pnemonia and one who developed systemic candidiasis were expired after operation. Conclusion: We suggests resection and reconstruction of trachea is optimal procedure for up to 6cm long tracheal lesions. However, for the patients with poor consciousness or poor general conditions would be the conservative treatment preferred to the tracheal reconstruction because of high serious complications and mortalities.

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The clinical study for the postoperative tracheal stenosis (수술후성 기관협착증에 관한 임사적 고찰)

  • 김기령;홍원표;이정권
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1977.06a
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    • pp.9.1-10
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    • 1977
  • Many etiological factors playa significant role in the development of tracheal stenosis; too high tracheostomy (Jackson, 1921), too small stoma (Greisen, 1966), the treatment with respirator using cuffed tube (Pearson et al., 1968; Lindholm, 1966; Bryce, 1972) and infection (Pearson, 1968). Although the incidence has been reduced due to development of surgical technique and antibiotics, the frequency of tracheal stenosis which produces symptoms after tracheostomy ranges from 1.5 per cent (Lindholm, 1967). In the management of the stenosis, mild cases are treated by mechanical dilatation with silicon tube or stent (Schmigelow, 1929; Montgomery, 1965) combined steroid (Birck, 1970), and in the cases of stenosis causes, these removed under the are bronchoscopy. But in severe stenosis, transverse resection with subsequent end-to-end anastomosis has been used in recent years (Pearson et al., 1968). During about 10 years, 1967 to 1977, a total of 23 patients with tracheal stenosis complicated among the 1, 514 tracheostomies have been treated in Severance Hospital. Now, we have obtained following conclusions by means of clinical analysis of 23 cases of tracheal stenosis. 1. The frequency of tracheal stenosis was 23 cases among 1, 514 cases of tracheostomy (1.5%). 2. Under the age of 5, these are 12 cases (52.2 %). 3. The sex incidence was comprised of 18 males and 5 females. 4. The duration of tracheostomy ranges from 4 days to 16 months. 5. The primary diseases requiring tracheostomy were following; central nerve system lesions 11 cases, upper air way obstruction 10 cases, extrinsic respiratory failure 2 cases. 6. Severe wound infections were only 2 cases. 7. The methods of treatment applied to tracheal stenosis were following; closed observation only 5 cases, nasotracheal intubation combined steroid 5 cases, T-tube stent combined steroid 3 cases, fenestration op. 4 cases, revision 4 cases and transverse resection and end-to-end anastomosis 2 cases.

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A Canine Model of Tracheal Stenosis Using Nd-YAG Laser (Nd-YAG laser를 이용한 기관협착 동물모델의 개발)

  • Kim, Jhin-Gook;Suh, Gee-Young;Chung, Man-Pyo;Kwon, O-Jung;Suh, Soo-Won;Kim, Ho-Joong
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.54-61
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    • 2002
  • Background: Tracheal stenosis is an urgent but uncommon disease. Therefore, primary care clinicians have limited clinical experience. Animal models of a tracheal stenosis can be used conveniently for the learning, teaching, and developing new diagnostic and therapeutic modalities for tracheal stenosis. Recently, a canine model of a tracheal stenosis was developed using a Nd-YAG laser. To describe the methods and results of developed animal model, we performed this study. Methods : Six Mongrel dogs were generally anesthetized and the anterior 180 degree of tracheal cartilage of the animal was photo-coagulated using a Nd-YAG laser. The animals were bronchoscopically evaluated every week for 4 weeks and a pathologic evaluation was also made. Results : Two weeks after the laser coagulation, the trachea began to stenose and the stenosis progressed through 4 weeks. All animals suffered from shortness of breath, wheezing, and weight loss in the 3 weeks after the laser treatment, and two died of respiratory failure just before the fourth week. The gross pathologic findings showed the loss of cartilage and a dense fibrosis, which resulted in a fibrous stricture of the trachea. Microscopy also showed that the fibrous granulation tissue replaced destroyed cartilage. Conclusion : The canine model can assist in the understanding and development of new diagnostic and therapeutic modalities for tracheal stenosis.

A case of recurrent respiratory infection resulting from a congenital anomaly of the bronchial tree tracheal bronchus (반복적인 호흡기 감염을 가진 환아에서 진단된선천성 기도 기형, 기관기관지 1예)

  • Choi, Ah-Reum;Choi, Sun-Hee;Kim, Seong-Wan;Sung, Dong-Wook;Rha, Yeong-Ho
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.660-664
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    • 2008
  • The term tracheal bronchus refers to an abnormal bronchus that comes directly off of the lateral wall of the trachea (above the carina) and supplies ventilation to the upper lobe. Tracheal bronchi occur almost exclusively on the right trachea and are associated with other congenital anomalies. In addition, tracheai bronchus may be related to other inflammatory conditions with persistent wheezing, such as recurrent pneumonia, chronic bronchitis and bronchiectasis, which is a result of the relatively poor local drainage of the involved bronchi. An infant with recurrent wheezing is likely to be a challenge for a clinician in the evaluation of the etiology of airway obstruction and in the differential diagnosis of wheezy breathing. The authors report a case of an 8-month-old female infant with a ventricular septal defect, who presented with stridor and recurrent respiratory infection and finally was finally diagnosed with a tracheal bronchus using computed tomography and a bronchoscopy. Therefore, tracheal bronchus should be included in the differential diagnosis of any child who presents with chronic or recurrent respiratory tract symptoms such as coughing, wheezing, stridor and recurrent respiratory infection, particularly in children with other congenital deformities.

Silicone Stent Placement for Primary Tracheal Amyloidosis Accompanied by Cartilage Destruction

  • Ryu, Duck Hyun;Eom, Jung Seop;Jeong, Ho Jung;Kim, Jung Hoon;Lee, Ji Eun;Jun, Ji Eun;Song, Dae Hyun;Han, Joungho;Kim, Hojoong
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.6
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    • pp.292-294
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    • 2014
  • Primary tracheal amyloidosis (PTA) can lead to airway obstructions, and patients with severe PTA should undergo bronchoscopic interventions in order to maintain airway patency. Focal airway involvements with amyloidosis can only be treated with mechanical dilatation. However, the PTA with diffused airway involvements and concomitant cartilage destructions requires stent placement. Limited information regarding the usefulness of silicone stents in patients with PTA has been released. Therefore, we report a case of diffused PTA with tracheomalacia causing severe cartilage destruction, which is being successfully managed with bronchoscopic interventions and silicone stent placements.

Superiorly Based Flap Tracheostomy (Superiorly based flap을 이용한 기관절개술)

  • 정필상;이정구;정필섭;김영훈
    • Korean Journal of Bronchoesophagology
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    • v.1 no.1
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    • pp.129-135
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    • 1995
  • The superiorly based flap tracheostomy(SBFT) has been advocated as an new technique of tracheostomy to manage a wide variety of causes of upper airway obstruction. This technique has particular applicability in patients who require long term tracheostomy such as in bilateral vocal cord paralysis and severe obstructive sleep apnea. SBFT has numerous advantages such as shortening of the gap between the skin and trachea : construction of a self-sustaining tract ; circumferential mucocutaneous junction to reduce infection, granulation tissue, bleeding, and stenosis of the tract : avoidance of the laryngotracheal damage : easy placement of a tracheostomal stent to promote speech, coughing and swallowing. Most of all, this technique can reduces the suprastomal buckling by the support of the superiorly based tracheal flap, and thus prevents the stenosis of suprastomal airway. The disadvantage of SBFT is more time-consuming procedure than the conventional tracheostomy, A retrospective analysis of 8 patients undergoing SBFT between June, 1994 and March, 1995 in Dankook University Hospital was performed to present the surgical technique and com-plication rates. The average duration of follow up was 11 months. The complications were consisted of a wound infection and a sternal granulation. The other complications including wound dehiscence, tracheitis, pneumonia, tracheal granulation, sternal narrowing and subglottic stenosis were not experienced.

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The Effects of Oyo-Tang(五拗湯) on the Respiratory Patterns and Tracheal Tissues in Allergic Asthma (오요탕(五拗湯)이 알레르기 천식(喘息)의 호흡(呼吸) 양상(樣相)과 기관(氣管) 조직(組織)에 미치는 영향(影響))

  • Kwon, Soon-Ho;Jung, Hee-Jae;Jung, Sung-Ki;Rhee, Hyung-Koo
    • The Journal of Korean Medicine
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    • v.20 no.2
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    • pp.98-107
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    • 1999
  • This study aimed to find out Oyo-Tang's effects on allergic asthma using the Egg-White Implant(EWI) method model recommended by Siqueira et al. Oyo-Tang has widely been prescribed and used in Oriental Medicine for controlling and curing of cough, nasal obstruction, pharyngeal pain and hoarseness. Previous studies have demonstrated that Oyo-Tang has analgesic, sedative, anticonvulsive, antitussive and antihistamine effects. But it was uncertain whether Oyo-Tang could inhibit the allergic reactions, to alleviate the symptoms of allergic asthma. With such aim. the respiratory patterns and eosinophil infiltration in the tracheal mucosa of rats with experimentally induced allergic asthma (using EWI method) were mainly observed. The results are as follows: 1. Oyo-Tang decreased the number of poor respiration with respect to control group (P<0.05) 2. Oyo-Tang decreased the number of eosinophils infiltrated in tracheal mucosa with respect control group (P<0.05). The above results demonstrate that Oyo-Tang has the inhibitory effects on the process allergic asthma and suggest that it could be used in relieving patients of the symptoms caused allergic asthma.

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Primary Tracheal Tumor C (원발성 기관 종양)

  • 이종호;문석환;조건현;왕영필;곽문섭;김세화
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.799-803
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    • 1998
  • Background: Tumors of the trachea are rare despite their histologic similarity to tumors of the main stem bronchus and lung. Materials and methods: Fourteen patients with tracheal tumor underwent surgical, radiational, or laser photocoagulation therapy from March 1981 to July 1996. Nine patients were malignant and five patients were benign. The most common malignant tumor was adenoid cystic carcinoma. Results: Age ranged from 10 to 65 years with mean age of 45.9 years. Most tumors were located middle and lower one-third of trachea. Surgery was done through collar incision, or collar incision with vertical partial sternal division, or left posterolateral thoracotomy, or sternal division with laryngeal release. Two patients died after operation, because of the disruption of anastomosis and airway obstruction,and laryngeal edema after suprahyoid release. Only one patient died after 8 month of diagnosis. The other patients were doing well during the follow-up period.

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The Effects of Kamihaepyoijin-tang on the Respiratory Patterns and Tracheal Tissues in Allergic Asthma (가미해표이진탕이 알레르기 천식 백서의 호흡 양상과 기관조직에 미치는 영향)

  • Kim Min Sue;Pack Dong Il
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.3
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    • pp.557-562
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    • 2002
  • The present study was made with the aim of finding out the Kamihaepyoijin-tang's effect on the allergic asthma using the Egg-White Implant(EWI) method model recommended by de Siqueira et al. Kamihaepyoijin-tang has widely been prescribed and used in Oriental Medicine for controlling and curing of cough, asthma, nasal obstruction. Previous studies have demonstrated that Kamihaepyoijin-tang had analgesic, anticonvulsive effects. But it is uncertain whether Kamihaepyoijin-tang could inhibit the allergic reaction of rats with experimentally induced allergic asthma using EWI method. With such aim. the respiratory patterns and eosinophil infiltration in the tracheal mucosa of the rats were mainly observed. The results were summerized as follows ; 1. The frequency of malformed respiratory patterns in Kamihaepyoijin-tang treated groups were decreased as compared with the control group. 2. The Ratio of malformed respiratory patterns in Kamihaepyoijin-tang treated groups were significantly decreased as compared with the control group(p<0.02). 3. The eosinophil infiltration in Kamihaepyoijin-tang treated groups were decreased as compared with the control group. 4. The eosinophil infiltration that inside of trachea tissue in Kamihaepyoijin-tang treated groups were significantly decreased as compared with the control group(p<0.05). Depending upon above results, it is considered that Kamihaepyoijin-tang has the inhibitory effects on the allergic asthma of rats and suggested that it could be used in relieving patients of the symptoms which are caused by allergic asthma.