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Mucoid Impaction of the Bronchus

Mucoid Impaction of Bronchi


Presentation

  • Collection includes both citations and many full-text, downloadable documents from mid-1900s to present. AULIMP - Air University Library Index to Military Periodicals.[dtic.mil]
  • His original paper was presented before the American Association for Thoracic Surgery in 1951 and was published in the Journal of Thoracic Surgery in August, 1951.[annals.org]
  • The first report of MIB in 1951 described dilated bronchi filled with inspissated mucus in five patients who presented with wheezing, cough, and a history of allergy [ 3 ].[ekjm.org]
  • Herein, we present a case using a Fogarty catheter through a flexible bronchoscope for the retrieval of a mucoid impaction with total unilateral lung collapse.[saudija.org]
Anorexia
  • There was no history of hemoptysis, anorexia, or weight loss. Her medical history was unremarkable and she denied any history of drug use.[ekjm.org]
  • There was no history of hemoptysis, anorexia, or weight loss. He had several episodes of “chest colds” in the past, which usually resolved with oral antibiotics.[rc.rcjournal.com]
  • They have systemic manifestations such as fever, malaise and anorexia. Sputum production is characterized by chunks of green to beige colored sputum plugs (5).[bioscience.org]
Hypoxemia
  • Although the rigid bronchoscope is solely used for the diagnosis and removal of obstructive material, [1] it has the potential risk of interrupting ventilation which leads to hypoxemia and dislocation of a foreign body could bring about a disastrous total[saudija.org]
Weakness
  • On his arrival at the emergency room, his left lung sounds were very weak, and wheezing was detected in the left lung.[saudija.org]
Rhinorrhea
  • The patient had a 4-week history of productive cough and rhinorrhea. She had been diagnosed with pneumonia ( Fig. 1A ) at a private clinic and had undergone medical treatment for it. There was no history of hemoptysis, anorexia, or weight loss.[ekjm.org]
  • He presented with a 2-week history of rhinorrhea, cough, and fever. His medical history was not significant. On his arrival at the emergency room, his left lung sounds were very weak, and wheezing was detected in the left lung.[saudija.org]
  • A study by Diwakar et al. shows that cough and dyspnea are the most common symptoms (99%). [4] Expectoration is seen in 98% patients, wheezes in 97%, and hemoptysis in 47% patients. [4] Fever is found in 80% cases, and nasal symptoms such as rhinorrhea[jacpjournal.org]
Persistent Cough
  • A 68-year-old woman was referred to our hospital because of persistent cough and wheezing lasting at least 4 years. Chest X-rays showed an infiltrative shadow in the right lower lung field.[jstage.jst.go.jp]
Withdrawn
  • The balloon of Fogarty catheter was inflated, and the mucoid impaction was carefully withdrawn over several passes [Figure 4] . There was no bleeding or damage to the tracheal mucosa.[saudija.org]
Quadriplegia
  • References Dee PM, Suratt PM, Bray ST, Rose EE Jr (1984) Mucous plugging simulating pulmonary embolism in patients with quadriplegia.[link.springer.com]

Workup

  • After initial workup, the patient underwent fiberoptic bronchoscopy, which revealed thick whitish secretions impacted in the right lower lobe, left upper lobe and left lower lobe bronchus, which proved difficult to be removed by the bronchoscope, prompting[annsaudimed.net]
  • A hyperlucency over her left upper lung zone was discovered incidentally 15 years prior for workup of a possible rib fracture. The patient endorsed episodes of pneumonia every 2 years since childhood.[omicsonline.org]
Atelectasis
  • These patients secrete a peculiarly viscid mucus, inspissation of which leads to bronchial occlusion and atelectasis, followed in some cases by suppuration and bronchiectasis.[birpublications.org]
  • Type your tag names separated by a space and hit enter Links Authors , Source MeSH Adult Asthma Bronchial Diseases Bronchitis Bronchography Female Humans Lung Abscess Male Middle Aged Mucus Pulmonary Atelectasis Radiography Tomography Pub Type(s) Case[wwww.unboundmedicine.com]
  • Atelectasis does not occur, probably because of collateral ventilation from adjacent uninvolved lung. Certain apparent differences have been noted between the adult (asthma) and childhood (CF) forms of MIB.[pediatrics.aappublications.org]
  • His chest radiograph revealed re-expansion of the left lung parenchyma and atelectasis in the right upper lobe [Figure 5] . ABGA with a FiO 2 showed the following results: pH 7.35, PCO 2 43 mmHg, PO 2 57.1 mmHg, and SpO 2 89.1%.[saudija.org]
Taenia Solium
  • The results of enzyme-linked immunosorbent assays (ELISAs) for the detection of infectious parasites (such as Clonorchis, Paragonimus, and cysticerci and spargana of tapeworms such as Taenia solium) were all negative.[ekjm.org]

Treatment

  • However, the effective treatment has not yet been established. Case. A 68-year-old woman was referred to our hospital because of persistent cough and wheezing lasting at least 4 years.[jstage.jst.go.jp]
  • Follow-up chest CT scan showing nearly resolved mucous impaction and consolidation in the right middle lung after treatment. CT, computed tomography. Figure 5.[ekjm.org]
  • Diagnosis and treatment. Am Rev Resp Dis 108:955–459 Google Scholar Jelihovsky T (1983) The structure of bronchial plugs in mucoid impaction, bronchocentric granulomatosis and asthma.[link.springer.com]
  • A long-term clinical follow-up along with serial chest x-ray of possible cases is needed to establish the effectiveness of treatment and long-term prognosis. References 1. Jelihovsky T.[annsaudimed.net]
  • Treatment There is significant debate regarding the treatment of bronchial atresia. Some doctors prefer to perform surgery on all patients [ 18 ].[medsci.org]

Prognosis

  • It has favorable response to steroid. 16 Acute mortality has been reported with mucoid impaction secondary to asphyxiation, but long-term prognosis has not been reported.[annsaudimed.net]
  • […] this has not yet developed in infants and young children, which is why the distal lung is rather hyperlucent in this population (e.g. congenital bronchial atresia, foreign body aspiration) distal airway dilatation double artery sign 9 Treatment and prognosis[radiopaedia.org]
  • A biopsy is the process of removing living tissue or cells from organs or other body parts of patients for examination under a microscope or in a culture to help make a diagnosis, follow the course of a disease, or estimate a prognosis.[medfriendly.com]
  • Park et al. mentioned that mucus impaction and plastic bronchitis are usually self-limited or responsive to medical therapy, with a good prognosis, although their patient did not respond to oral corticosteroid or intrabronchial instillation of acetylcysteine[f1000research.com]

Etiology

  • Some case reports have shown an association with endotracheal intubation 6 and transtracheal oxygen catheter insertion, 7 and also in children with cyanotic heart diseases. 8 Only a few case reports of mucoid impaction of unknown etiology are described[annsaudimed.net]
  • Diagnosis Congenital bronchial atresia; right lower lobe Discussion Bronchial atresia is a congenital anomaly of unknown etiology, in which a segmental bronchus fails to communicate with the central airways.[appliedradiology.com]
  • Etiology ABPA: Asthma: Chronic Bronchitis: Cystic Fibrosis: Distal to Central Airway Obstruction: associated with Bronchial Carcinoid, Bronchial Atresia, or Bronchial Cyst BCG: Lung Cancer: Physiology Mucoid impaction within proximal segment bronchus[mdnxs.com]
  • Etiology Mucoid impaction may result from either obstructive or non-obstructive causes, although the latter does eventually obstruct the bronchi as well: Non-obstructive Non-obstructive causes are infectious or inflammatory in nature: cystic fibrosis[radiopaedia.org]

Epidemiology

  • Pediatric plastic bronchitis: case report and retrospective comparative analysis of epidemiology and pathology . Case Rep Pulmonol. 2013 ;2013: 649365 . Google Scholar Medline 15. Jelihovsky, T .[journals.sagepub.com]
  • Traction bronchiectasis is restricted to the areas of end-stage fibrosis and particularly affects peripheral bronchi, which lack cartilage support. [51] Epidemiology A review of nontuberculous mycobacteria-associated hospitalizations showed a significant[emedicine.medscape.com]
  • Original Article Introduction Bronchial asthma is a common chronic disease worldwide affecting 1% to 18% of the population in different countries ( 1 ), and a recent epidemiologic study reported that the prevalence of asthma in China was 0.5% to 5% with[jtd.amegroups.com]
Sex distribution
Age distribution

Pathophysiology

  • […] impaction, patients end up with wrongful thoracotomy and lung resections, but awareness of this condition, and radiological and bronchoscopic findings could help avert unnecessary diagnostic and surgical intervention. 3,4,14,15 Although no definitive pathophysiology[annsaudimed.net]
  • Although the pathophysiology is not clearly understood, it is commonly seen in children with congenital heart diseases, cardiac and pericardial diseases in adults and in patients with chronic asthma 6 .[f1000research.com]
  • Pathophysiology Bronchiectasis is not caused by a single factor, but is a complex interplay between repeated inflammation and a defective immune response to inflammation. [29] Many congenital or acquired abnormalities can prevent normal airway defense[emedicine.medscape.com]
  • Understanding airway pathophysiology with computed tomograpy. J Appl Physiol (1985) 2003;95:854-62. [ PubMed ] Park JW, Hong YK, Kim CW, et al.[jtd.amegroups.com]

Prevention

  • Pathophysiology Bronchiectasis is not caused by a single factor, but is a complex interplay between repeated inflammation and a defective immune response to inflammation. [29] Many congenital or acquired abnormalities can prevent normal airway defense[emedicine.medscape.com]
  • Treatment with corticosteroids appears to prevent the progression of the disease. 2.[bioscience.org]
  • GLOBAL Strategy for Asthma Management and Prevention - (1995). NHLBI/WHO Workshop. National Institutes of Health, National Heart, Lung, and Blood Institute, Publication Number 95-3659. [ Links ] 9.[scielo.br]
  • References Global Strategy for Asthma Management and Prevention. Global Initiative for Asthma (GINA), 2014. Available online: www.ginasthma.org, accessed on August 12, 2014. Ge JB, Xu YJ. Internal Medicine.[jtd.amegroups.com]

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