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Bronchial Obstruction


Presentation

  • Despite attempts at palliative endoscopic argon coagulation, the patient expired soon after presentation.[ncbi.nlm.nih.gov]
  • Pulmonary schwannomas are exceedingly rare and can present a diagnostic challenge. We present a case of an endobronchial schwannoma presenting with bronchial obstruction and review the literature of this unusual entity.[ncbi.nlm.nih.gov]
  • A case is presented in which the Nd:YAG laser obviated the need for a major thoracic procedure. A 7-year-old boy presented with an 18-month history of persistent nonproductive cough, preceded by a choking spell while eating pistachio nuts.[ncbi.nlm.nih.gov]
  • Atypical mycobacterial infection in HIV-negative children usually presents with cervical lymphadenopathy.[ncbi.nlm.nih.gov]
  • Although a significant amount of bronchial occlusion may be present, symptoms of obstruction might not be apparent. Hemoptysis should always be thoroughly investigated, as it may be the only sign of a severe underlying disease.[ncbi.nlm.nih.gov]
Dyspnea
  • The responder rates for dyspnea were 79.3% for gap indexes over 0.06 seconds and 55.6% for gap indexes of 0.06 seconds or under.[ncbi.nlm.nih.gov]
  • Dyspnea significantly increased when the airway lumen was obstructed by more than 60% (p 0.0001), and when the P-P curve appeared loop-shaped (p 0.01).[ncbi.nlm.nih.gov]
  • We observed clinical improvement in terms of reduced dyspnea or controlled haemoptysis in 93% of our patients.[ncbi.nlm.nih.gov]
  • Bronchial asthma is a chronic disease characterized by episodic bronchial obstruction and ventilatory insufficiency and is manifested clinically by wheezing respirations, dyspnea, cough, and mucoid sputum production.[annals.org]
  • Clinical Observation A 55-year-old male farm worker with a 2-year history of illness characterized by cough, dyspnea, and wheezing was treated in our hospital.[archbronconeumol.org]
Tracheal Deviation
  • A new chest x-ray showed complete collapse of the left lung, with remarkable tracheal deviation. Computed tomography revealed a large endobronchial lesion causing occlusion of the left main bronchus and significant mediastinal shift to the left.[ncbi.nlm.nih.gov]
Blepharospasm
  • It can create excessive tearing, conjunctivitis, uncontrolled blinking (blepharospasm) and a sensation of burning and pain at initial exposure. Pulmonary edema (ARDS) and/or diffuse airway lesions on human would be lethal after CS inhalation.[ncbi.nlm.nih.gov]
Subcutaneous Emphysema of the Neck
  • A 30-week preterm infant ventilated for respiratory distress syndrome developed severe right-sided pulmonary interstitial emphysema, pneumomediastinum, and subcutaneous emphysema involving the neck.[ncbi.nlm.nih.gov]
  • Chest X-ray showing hyperinflated lungs and a discrete subcutaneous emphysema at the neck and the upper mediastinum (arrows).[f1000research.com]
Impulsivity
  • We investigated the relation between LSA and impulse oscillometry with the evaluation of peripheral airway obstruction.[ncbi.nlm.nih.gov]
  • Ninety-nine children hospitalized for bronchiolitis at the age of less than 6 months were studied with impulse oscillometry (IOS) at the mean age of 6.3 years.[ncbi.nlm.nih.gov]
  • Handa H, Huang J, Murgu SD, Mineshita M, Kurimoto N, et al. (2014) Assessment of central airway obstruction using impulse oscillometry before and after interventional bronchoscopy. Respir Care 59: 231–240. View Article Google Scholar 15.[journals.plos.org]

Workup

  • . • Investigations add little in the initial workup • As viral croup is the commonest cause of UAO, attempts to identify other causes is also very important to confirm the diagnosis. 16.[slideshare.net]
  • Radiology Chest radiography (CXR) is universal for patients presenting with most respiratory symptoms and is the first step in the radiologic workup.[jtd.amegroups.com]
Atelectasis
  • The interval between the improvement of atelectasis and the development of pneumothorax varied by less than three weeks.[ncbi.nlm.nih.gov]
  • A case is presented of acquired obliterative mainstem bronchial obstruction with total ipsilateral lung atelectasis and contralateral lung hyperexpansion.[ncbi.nlm.nih.gov]
  • This causes lung collapse (atelectasis), then pneumonia. As Dr. Chevalier Jackson stated, “Not all that wheezes is asthma!” Did You Know?! In the European Union each year, an estimated 50,000 children (14 years or younger) have a choking episode.[dontchoke.ubc.ca]
  • In addition, a CT-scan of the chest was performed and showed evidence of left upper lobe consolidation or atelectasis with a possible mass in the left upper lobe bronchus.[academic.oup.com]
  • They can cause wheezing, atelectasis, infections, dyspnea and sometimes hemoptysis [ 35 ]. On bronchoscopy the tumor appears solitary, smooth and well circumscribed.[omicsonline.org]
Mediastinal Shift
  • Computed tomography revealed a large endobronchial lesion causing occlusion of the left main bronchus and significant mediastinal shift to the left. Despite the collapse of the left lung, no symptoms of bronchial obstruction were evident.[ncbi.nlm.nih.gov]
  • Conclusion: Obstruction of the right main bronchus by a soft tissue mass resulting in airless "drowned" right lung with subsequent volume loss and mediastinal shift. Impression of multiple pulmonary metastases. Right paratracheal lymphadenopathy.[radiopaedia.org]
  • Chest radiography reveals left-sided volume loss with mediastinal shift and multifocal heterogeneous opacities within the mid-lower left lung field. There is a small left pleural effusion.[clevelandclinicmeded.com]
  • Radiographic findings may demonstrate, endobronchial lesions, atelectasis , pneumonia , bronchiectasis and in some instances even mediastinal shift. Imaging modalities are often non-specific.[omicsonline.org]

Treatment

  • ) in the high-dose treatment group vs. the low-dose treatment group.[ncbi.nlm.nih.gov]
  • We suggest that sevoflurane inhalation may be a therapeutic option in the treatment of young infants with severe bronchiolitis who respond poorly to conventional therapy.[ncbi.nlm.nih.gov]
  • We observed one treatment-related death (overall mortality 0.4%). Bronchoscopic laser therapy is a generally safe and effective method to regain airway patency in cases with tracheal or bronchial obstruction and to treat haemoptysis.[ncbi.nlm.nih.gov]
  • A primary lung abscess due to non type B Hemophilus influenzae was diagnosed in three children who failed to improve after prolonged antibiotic treatment for dense, pneumonic infiltrates.[ncbi.nlm.nih.gov]
  • Despite antibiotic treatment, the obstruction had not been resolved. To relieve the bronchial obstruction, bronchoscopic intralesional injection of triamcinolone acetonide was performed without any complications.[ncbi.nlm.nih.gov]

Prognosis

  • However, the ultimate prognosis is of course associated with the underlying condition.[patient.info]
  • The prognosis is poor with squamous cell carcinoma of the trachea, which carries a 5-year survival of approximately 40% when resectable and 7% when unresectable.[clinicaladvisor.com]
  • […] especially when being prepared for children Consume food slowly and fully chew food before swallowing, which is an effective preventative method Closely watch very young children while they play with toys and small play items (toy parts) What is the Prognosis[dovemed.com]
  • Prognosis after an airway obstruction With prompt treatment, an airway obstruction can often be treated successfully. However, airway obstructions are extremely dangerous. They can be fatal even with treatment.[healthline.com]

Etiology

  • Current understanding of the inflammatory process in cystic fibrosis: Onset and etiology. Pediatr Pulmonol 1997;24:137–142. PubMed CrossRef Google Scholar 287. Pier GB, Grout M, Zaidi TS, et al.[link.springer.com]
  • The role of function in the etiology and treatment of malocclusion. Am J Orthod , 1979;54:883-98. Linder-Aaronson S, Woodside DG. Excess Face Height Malocclusion: Etiology, Diagnosis and Treatment . Chicago: Quintessence Publishing Co., 2000.[massagetoday.com]
  • ETIOLOGY • Passive smoking • Exposure to chemical, air pollution • Inhalation of smoke • Hereditary factors 59.[slideshare.net]
  • Etiology-specific treatment 1. Aspiration of Food or Foreign Body Use of the Heimlich maneuver in an individual who suddenly is unable to speak while eating (a so-called, “café coronary”) may relieve the obstruction. 2.[clinicaladvisor.com]
  • (Etiology) An Acute Upper Airway Obstruction is most often caused by blocked or obstructed upper airway that occurs due to the presence of foreign items that may include food, small toy parts, and other small objects.[dovemed.com]

Epidemiology

  • He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education.[lifeinthefastlane.com]
  • In children, the most common causes are T-cell acute lymphoblastic leukaemia and non-Hodgkin's lymphoma (T-cell lymphoblastic lymphoma). [ 5 ] Epidemiology Gender predilection reflects aetiology, with more males than females due to the prevalence of lung[patient.info]
  • Epidemiology Approximately 80,000 cases of malignant airway obstruction are treated annually in the United States. Cases of CAO occur in 20% to 30% of lung cancer patients.[clevelandclinicmeded.com]
  • Gender differences in sleep apnea: epidemiology, clinical presentation and pathogenic mechanisms. Sleep Med Rev, 2003;7:377-89. Baldwin CM, Bootzin RR, Schwenke DC, Quan SF.[massagetoday.com]
  • Epidemiology Frequency Most airway foreign body aspirations occur in children younger than 15 years; children aged 1-3 years are the most susceptible.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • From a pathophysiologic perspective, the changes that occur in asthma are multiple, diverse, and complex.[ncbi.nlm.nih.gov]
  • The National Heart, Lung, and Blood Institute estimated that total COPD costs were 32.1 billion in 2002 ( 18 billion in direct medical costs and 14.1 billion in indirect medical costs). 10 While improved understanding of the underlying pathophysiology[ajmc.com]
  • Pathophysiology After foreign body aspiration occurs, the foreign body can settle into 3 anatomic sites, the larynx, trachea, or bronchus. Of aspirated foreign bodies, 80-90% become lodged in the bronchi.[emedicine.medscape.com]
  • Gavin Joynt Pathophysiology - obstruction is likely to occur at sites of anatomic narrowing such as the hypopharynx at the base of the tongue and the false and true vocal cords at the laryngeal opening. - sites of airway obstruction are referred to as[aic.cuhk.edu.hk]
  • Patient with large tracheal tumor Pathophysiology of variable intrathoracic obstruction: During expiration, the expiratory muscles increase intra-thoracic and intra-airway pressures.[clinicaladvisor.com]

Prevention

  • Different techniques of reinforcing the bronchial stump to prevent this complication have been described. Pledgeted sutures have been suggested for this purpose but have the potential to erode into the bronchus years after resection.[ncbi.nlm.nih.gov]
  • According to previous cases, a bronchial balloon of double-lumen endotracheal tube (DLT) could prevent a dislodged tumor from traveling to the contralateral lung.[ncbi.nlm.nih.gov]
  • Centers for Disease Control and Prevention. Asthma prevalence and control characteristics by race/ethnicity–United States, 2002. MMWR Morb Mortal Wkly Rep . 2004;53:145-148. 2. Centers for Disease Control and Prevention.[ajmc.com]
  • Prevention Unlike some diseases, COPD has a clear cause and a clear path of prevention. The majority of cases are directly related to cigarette smoking, and the best way to prevent COPD is to never smoke — or to stop smoking now.[mayoclinic.org]
  • There are no definitive methods to prevent Acute Upper Airway Obstruction. However, proper precautions may be taken to reduce risks.[dovemed.com]

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