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Obstructions of the trachea (windpipe) and bronchi (large air passages in the lungs) in an infant or child usually can be corrected surgically. In infants and children, even mild airway obstructions need to be treated immediately. Because of the small size of an infant's airway, even a minimal amount of swelling of the mucosal lining may result in severely decreased flow of air. The results of treatment of 45 infants and children with intrathoracic tracheobronchial obstructions who required surgery are presented. There were four premature infants with tracheal atresia (absence of a normal opening); all died soon after birth. Eighteen patients had congenital stenosis (narrowing); all had symptoms of stridor (a high-pitched breathing sound) from birth, and all except one baby had other birth defects. Four babies died before surgery could be performed (24 hours to 4 months after symptoms began). Thirteen patients had surgical correction and reopening of the airway. Severe tracheomalacia (softening and sponginess of the trachea) necessitated surgery in 16 patients; 6 had other associated abnormalities, and 9 had tracheomalacia associated with atresia of the esophagus. One patient had tracheal stenosis due to trauma, and one patient had a polyp in the far trachea. Bronchial stenosis was present in four patients; one case appeared to be congenital. When narrowing involves less than 50 percent of the length of the trachea, resection can be performed, but if it involves more than 50 percent, a graft of rib cartilage should be used. It is concluded from this experience that segmental tracheobronchial resection and re-resection of recurrent stenosis is highly successful. (Consumer Summary produced by Reliance Medical Information, Inc.)

Bronchoscopy and bronchography revealed a very rare abnormality in the embryonal anatomy of the right bronchial tree in a 54-year-old woman with cough. There was a proximal migration of the [...]

Most coughs in children respond to diagnostic interventions or cough therapy. A cough that does not respond to any treatment is termed intractable cough. Since a cough can disrupt the quality of a child's life in school and at home, it has been hypothesized that some coughs may be psychological. Children who were referred for bronchoscopy, visual inspection of the breathing structures using a magnifying lens, were examined for anatomical abnormalities associated with retractable cough. Out of 2,059 children referred for bronchoscopy, 37 had a persistent cough. Of these, eight were diagnosed with a deep, brassy, nonproductive intractable cough. In seven male patients, an anatomical abnormality, tracheomalacia (softening of the cartilage of the trachea), was found. One boy without a physical abnormality had total collapse of the bronchus during coughing. All the boys reported coughing during sleep, which is not characteristic of psychogenic cough. It is hypothesized that contact of the membranous and cartilaginous portion of the airway during coughing created an irritation which lead to more coughing, ultimately creating a vicious cycle. It is possible however, that some cases having an anatomical abnormality also have a psychogenic component. Conversely, some patients with severe tracheomalacia do not have intractable cough. Bronchoscopy is recommended for children with deep, brassy, intractable cough. (Consumer Summary produced by Reliance Medical Information, Inc.)

(CHEST 2001; 119:955-957) A 52-year-old woman was referred to the hospital for management of recurrent hemoptysis. She also reported an episode of hematemesis, which was initially thought to be unrelated [...]

(CHEST 2001; 119:947-949) A 39-year-old man was seen in the emergency department for vague abdominal pain. The workup at that time was unrevealing, and the pain resolved with symptomatic treatment. [...]

Mariana C Petrozzi(*); R C Gilkeson and P Lange.. PURPOSE: To define the clinical and radiologic features of bronchial atresia, a rare congenital anomaly of the tracheobronchial tree. To define [...]

Introduction: Congenital bronchopulmonary and vascular malformations are a diverse and complex group of lesions. We describe a patient with systemic arterialization of otherwise normal lung, a rare manifestation of the [...]

Introduction: Congenital bronchopulmonary malformations are rare lesions that may become apparent at any age. Pulmonary sequestration is defined as a cystic nonfunctioning lung tissue that usually has no communication with [...]

We report two cases of tracheobronchomegaly with differing presentations. The radiologic, fiberoptic bronchoscopic, and clinical findings as well as management of this rare condition are reviewed. (Chest 1994; 106:1589-90) CT=computed [...]

A 63-year-old man who underwent single lung transplantation for advanced emphysema had a postoperative course complicated by asymptomatic bronchial dehiscence associated with a large broncholith. The stone eventually caused airway [...]

A 36-year-old woman with features of both the Mounier-Kuhn syndrome and the Kenny-Caffey syndrome is described. To our knowledge, this is the first reported case of these syndromes occurring together. [...]

Gregor P.M. Mannes, M.D.;(*1) Eric J. van der Jagt, M.D.;([unkeyable]) Bert Wouters, M.D.;([unkeyable]) and Pieter E. Postmus, M.D.([unkeyable]) A 15-year-old girl complained of periods of intermittent dyspnea with wheezing. Smoke [...]