Page Source : https://onlinelibrary.wiley.com/doi/10.1111/resp.13700_419
AP1736
Ka Kiat Chin1, Thian Chee Loh1, Chee Shee Chai2, Jiunn Liang Tan1, Mau Ern Poh1, Chee Kuan Wong1, Yong Kek Pang1, Chong Kin Liam1
1Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia, and 2Department of Medicine, Faculty of Medicine Health Sciences, Universiti Malaysia Sarawak (UNIMAS), Kota Samarahan, Sarawak
Background
Endobronchial tuberculosis (EBTB) is the tuberculous infection of the tracheobronchial tree. Diagnosis of EBTB is often challenging, due to the non-specific symptoms with insidious onset. Despite effective antituberculous drugs, complications such as bronchial stenosis and lung collapse still arise. We would like to discuss a case of post-tuberculosis bronchial stenosis and the role of bronchoscopic balloon dilatation.
Case Report
A 20-year-old gentleman, with a history of treated pulmonary tuberculosis in 2018 presented with worsening breathlessness and cough. Chest radiograph revealed a total left lung collapse. Flexible bronchoscopy showed complete stenosis of left upper lobe bronchus with a narrowed orifice of the left lower lobe bronchus. He underwent balloon dilatation of left lower lobe bronchus up to a diameter of 10mm. A second balloon dilatation was repeated after 2 months. Subsequent chest radiograph revealed re-expansion of the left lung. No restenosis showed during surveillance bronchoscopy after six months. He remained asymptomatic with the Modified Medical Research Council (mMRC) scale of 0.
Conclusion
Numerous bronchoscopic intervention proposed such as airway stenting, laser resection and cryotherapy aim to restore the airway patency. Nonetheless, balloon dilatation is still the choice of preference. The procedure is simple to perform, least invasive and provide immediate symptomatic relief. This case highlights the effectiveness of bronchoscopic balloon dilatation and potentially avoiding the need for stent insertion or surgical intervention.
