Iatrogenic Tracheal Stenosis Presenting as Persistent Asthma

Barreiro, Timothy J.; Ghattas, Christian; Valino, Cherry Ann

doi:10.4187/respcare.02231

Cited by 9 publications

(4 citation statements)

References 21 publications

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“…The overall incidence of SGS is decreasing after new technologies and only 2% of the patients are symptomatic. Generally prolonged intubation is accused for mucosal injury and tracheal stenosis is rare when intubation was <1 week [7]. In our case the patient developed SGS after intubation of <24 hours and this is a rare condition.…”

Section: Discussionmentioning

confidence: 54%

“…Airway trauma, inhalation burns and irradiation are the other acquired causes of SGS [6]. The incidence of acquired tracheal stenosis was reduced by development of high-volume, low-pressure ETT cuffs while comorbidities like myocardial infarction and congestive heart failure enhances mucosal damage [7]. Our case had a history of CAD and IHD as a predisposing factor without any respiratory disorder.…”

Section: Discussionmentioning

confidence: 91%

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A Case Report: Subglottic Stenosis Observed in Early Postoperative Period

Mungan¹

2018

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 91%

A Case Report: Subglottic Stenosis Observed in Early Postoperative Period

Mungan¹

2018

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“…The usual presenting symptoms are shortness of breath and stridor which start after 1–6 weeks of extubation in most reports. The tracheal diameter is less than 50% when these symptoms appear [ 18 ]. In cases of post intubation stenosis, usually symptoms start after one week.…”

Section: Discussionmentioning

confidence: 99%

Nonmalignant tracheal stenosis: presentation, management and outcome in limited resources setting

Gulilat,

Genetu,

Kejela

et al. 2024

J Cardiothorac Surg

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Background Nonmalignant tracheal stenosis is a potentially life threatening conditions that develops as fibrotic healing from intubation, tracheostomy, caustic injury or chronic infection processes like tuberculosis. This is a report of our experience of its management with tracheostomy, rigid bronchoscopic dilation and surgery. Methods Retrospective study design was used. 60 patients treated over five years period were included. Results Mean age was 26.9 ± 10.0 with a range of 10–55 years. Majority (56 patients (93.3%)) had previous intubation as a cause for tracheal stenosis. Mean duration of intubation was 13.8 days (range from 2 to 27 days). All patients were evaluated with neck and chest CT (Computed Tomography) scan. Majority of the stenosis was in the upper third trachea − 81.7%. Mean internal diameter of narrowest part was 5.5 ± 2.5 mm, and mean length of stenosed segment was 16.9 ± 8 mm. Tracheal resection and end to end anastomosis (REEA) was the most common initial modality of treatment followed by bronchoscopic dilation (BD) and primary tracheostomy (PT). The narrowest internal diameter of the tracheal stenosis (TS) for each initial treatment category group was 4.4 ± 4.3 mm, 5.1 ± 1.9 mm and 6.7 ± 1.6 mm for PT, tracheal REEA and BD respectively, and the mean difference achieved statistical significance, F (10,49) = 2.25, p = 0.03. Surgery resulted in better outcome than bronchoscopic dilation (89.1% vs. 75.0%). Discussion and conclusion Nonmalignant tracheal stenosis mostly develops after previous prolonged intubation. Surgical resection and anastomosis offers the best outcome.

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“…Inhalation drugs represent the first therapeutic option and include variable doses of corticosteroids ± β2-agonist bronchodilators according to the severity of the disease [ 3 ]. A wide range of pathologies, including upper airway stenosis and vocal cord dysfunction, may mimic bronchial asthma [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Avoiding misdiagnosis in patients with dyspnea and wheezing: a case report illustrating the clinical implications of fixation error

et al. 2017

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BackgroundBronchial asthma is a heterogeneous respiratory condition which can be mimicked by a wide range of pathologies including upper airways stenosis. The accurate diagnosis of asthma, as with other conditions, may be influenced by fixation errors, which are common in medicine and occur when a physician concentrates on only one element of a clinical case without considering other relevant aspects. Here we report a challenging case characterized by the contemporaneous presence of a common disease, asthma, together with a rare respiratory disease, idiopathic tracheal stenosis.Case presentationThe 56-year-old female patient, a former smoker, was referred to our outpatient clinic for exertional dyspnea and persistent wheezing. There were no other respiratory or systemic symptoms over the past three months, and a psychological component was suspected. Spirometry with flow-volume evaluation and bronchoscopy were the key elements to establish the diagnoses and provide treatments. Once the diagnosis of asthma was confirmed, the combination of the anti-inflammatory corticosteroid fluticasone and the rapid-acting bronchodilator formoterol in a single inhaler effectively controlled the patient’s symptoms, confirming the favorable efficacy and safety profile which are reflected in the recommendations of the international guidelines.ConclusionsIn this paper we describe the clinical investigations and interventions that eventually confirmed a diagnosis of asthma complicated by an idiopathic tracheal stenosis and led to effective treatment of the patient. Awareness of fixation error may avoid misdiagnosis in patients with respiratory disease and a complicated history at presentation.

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Iatrogenic Tracheal Stenosis Presenting as Persistent Asthma

Cited by 9 publications

References 21 publications

A Case Report: Subglottic Stenosis Observed in Early Postoperative Period

A Case Report: Subglottic Stenosis Observed in Early Postoperative Period

Nonmalignant tracheal stenosis: presentation, management and outcome in limited resources setting

Avoiding misdiagnosis in patients with dyspnea and wheezing: a case report illustrating the clinical implications of fixation error

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