Novel bronchoscopic balloon dilation for patients with bronchostenosis caused by bronchial tuberculosis: a case report

J Med Case Rep. 2014 Jun 24:8:225. doi: 10.1186/1752-1947-8-225.

Abstract

Introduction: Bronchoscopic balloon dilation is a common method in the treatment of bronchostenosis but it is not an effective treatment due to its short dilating time (3 minutes) and low pressure (<3atm). Until recently, the reported highest dilating pressure was ≤6atm; however, this is not enough pressure to dilate a bronchostenosis because of the resistance of the bronchus. We hypothesized that higher dilating pressure (up to 14atm) with longer dilating time (40 minutes) may make bronchoscopic balloon dilation treatment more effective according to the blood vessel dilating method. Therefore, we designed this new bronchoscopic balloon dilation method for treating bronchostenosis, particularly in cases caused by bronchial tuberculosis.

Case presentation: A 23-year-old Chinese woman presented with right middle segmental bronchostenosis caused by bronchial tuberculosis. She was informed of the surgical procedure and she provided informed consent. After taking anti-bronchial tuberculosis drugs for 2 months, she underwent our new bronchoscopic balloon dilation treatment (dilating time, 40 minutes; pressure, 14atm). After anti-bronchial tuberculosis treatment for 13 months, her intermediate bronchus was observed with videobronchoscopy again and no re-stenosis was seen. Furthermore, a computed tomography scan revealed that her right lower lobe and right middle lobe had reopened. No complications occurred in the patient.

Conclusion: The novel high-handed videobronchoscopic balloon dilation method was safe and effective for treating this patient with bronchostenosis caused by bronchial tuberculosis.

Publication types

  • Case Reports

MeSH terms

  • Antitubercular Agents / therapeutic use*
  • Bronchial Diseases / diagnostic imaging
  • Bronchial Diseases / etiology
  • Bronchial Diseases / surgery*
  • Bronchoscopy / methods*
  • Constriction, Pathologic / diagnostic imaging
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / surgery*
  • Dilatation / methods*
  • Ethambutol / therapeutic use
  • Female
  • Humans
  • Isoniazid / therapeutic use
  • Lung / diagnostic imaging*
  • Pyrazinamide / therapeutic use
  • Radiography
  • Rifampin / therapeutic use
  • Treatment Outcome
  • Tuberculosis, Pulmonary / complications
  • Tuberculosis, Pulmonary / drug therapy*
  • Young Adult

Substances

  • Antitubercular Agents
  • Pyrazinamide
  • Ethambutol
  • Isoniazid
  • Rifampin