CT Evaluation of Unilateral Destroyed Lung among Bangladeshi Population

Abstract

The unilateral destroyed lung is an important cause of morbidity and mortality. The commonest cause of destroyed lung is total post tuberculous sequelae. Primary lung tumors, mediastinal masses, vascular abnormalities, and some others are considered to be other causes of lung destruction. A study was undertaken at the National Institute of Diseases of the Chest and Hospital (NIDCH) on 600 cases from January 2016 to December 2020 to evaluate the etiopathogenesis of unilateral lung destruction and to evaluate hilar structures & the nature and extent of parenchymal damage. The study was performed on 600 patients with unilateral lung destruction, of whom 416(69.33%) had left lung destruction. Pulmonary tuberculosis was found to be the cause in 504(84%) patients. All patients had an X-ray chest and CT scan of the chest (contrast CT/ HRCT). However, 96(16%) non-tuberculous patients had their main bronchi occluded with extraluminal compression or by the intraluminal lesion.
 TAJ 2021; 34: No-1: 75-79

Destroyed Lung Syndrome in a Young Indian Male: A Case Report

“…Extensive tuberculous lung destruction-related mortality is high and is mostly associated with massive hemoptysis, superinfections, respiratory failure, or the presence of active tuberculosis [20]. Furthermore, hemoptysis due to hypertrophied bronchial arteries or Rasmussen aneurysms could result in lethal complications in cases with tuberculous destroyed lung syndrome [11]. Furthermore, severe complications, such as septicemia/empyema and left-right shunt, are also reported in cases of destroyed lung syndrome [13].…”

“…Radiological studies help in establishing the diagnosis and are characterized by a remarkably reduced ventilation-to-perfusion ratio [ 10 ]. Tuberculosis is reported as the commonest cause of a destroyed lung, and it could happen after a primary disease or reinfection [ 4 , 11 ]. However, there is a paucity of literature related to it, and there is no exact prevalence or incidence known.…”

“…The clinical presentations are mostly chronic, but acute cases are also documented [ 13 ]. The patient may present with prolonged and frequent episodes of respiratory illnesses, purulent (yellow-colored) expectoration, chronic low-grade fever, dyspnea, chest tightness, and generalized ill health and may be complicated with episodes of recurrent hemoptysis [ 4 , 11 , 13 ]. Acute symptoms of septicemia, massive hemoptysis, or respiratory failure may also be present [ 11 ].…”

“…Post successful completion of anti-tubercular treatment, this lung damage is incapacitating for patients and linked with adverse outcomes beyond completion of anti-tubercular treatment [ 15 ]. In another study by Hossain et al from Bangladesh on 600 study subjects, nearly 70% had destruction of the left lung [ 11 ]. Furthermore, tuberculosis was attributed as the basis of lung destruction in 84% of the study subjects [ 11 ].…”

Multidrug-resistant Tuberculosis and COVID-19 Coinfection with Diabetes Mellitus in Medan, Indonesia: A Case Report

“…The destroyed lung may cause severe complications such as massive hemoptysis, septicemia, and left-right shunt requiring urgent medical attention. The shunt can produce pulmonary hypertension and respiratory failure despite having a normal contralateral lung [14].…”