Resection of Tuberculous Strictures of the Main Bronchi in Three Cases

Jw, Jackson; Ph, Jones; Th, Sellors

doi:10.1136/thx.10.3.229

Cited by 4 publications

(2 citation statements)

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“…Recently Jackson, Jones, and Sellors (1955) have reported the successful excision of tuberculous strictures with end-to-end anastomosis. They state that the bronchial artery supply is interrupted by the division of the bronchus, but this does not appear to jeopardize the vitality of the junction.…”

Section: Discussionmentioning

confidence: 99%

Six Cases of Traumatic Rupture of the Bronchus

Bates¹,

Beard²

1956

Thorax

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The operative repair of traumatic rupture of the bronchus, until a few years ago a matter for conjecture, has now proved successful on several occasions. Two such cases are presented here, and reports of four other cases of traumatic bronchial rupture. Together, the six cases show a variety of ways in which the condition may end; two have had atelectatic lungs for many years, a third had a pneumonectomy within two weeks of the accident, the fourth and fifth cases have healthy, functioning lungs after late operative repair of the injured bronchus, and the sixth case appears likely to make a satisfactory spontaneous recovery.In discussing the cases some of the literature is reviewed and certain points which are of importance in diagnosis and treatment are noted. of 10 she had left-sided pleurisy and was in bed for three to four weeks ; this condition recurred at the age of 18 and she was in bed for three weeks. For the last two years she had had persistent cough and sputum throughout the year; the sputum became yellow when she had a cold. The sputum had been occasionally blood-stained. As a result of a mass radiograph in 1954 she was advised to seek a surgical opinion.On examination the patient was thin but otherwise fit. The fingers were not clubbed. Gross inspiratory stridor was present. Chest examination revealed that the trachea deviated to the right; there was good expansion of both sides, but the left expanded better than the right. The percussion note was resonant all over the chest and there were normal breath sounds on both sides; there were no added sounds. The pulse was 80, regular. The jugular venous pressure was not raised. Blood pressure readings in the right arm gave 115/80 mm. Hg, in the left arm 110/80 mm. Hg. The apex beat of the heart was palpable in the fifth interspace in the right axilla; heart sounds were normal. The abdomen and central nervous system were healthy.A chest radiograph (Fig. 1) showed the heart lying entirely in the right posterior chest. The left lung filled both sides of the chest and there was no sign of the right lung. Acid-fast bacilli were not found in the sputum, but culture gave a heavy growth of Staphylococcus aureus. Haemoglobin was 12.4 g. %.Nothing abnormal was found in the urine.On November 19, 1954, bronchoscopy was performed by Mr. Tubbs. The cords and trachea were normal. There was moderate stenosis of the left main bronchus at its origin. Below this the lumen was of normal calibre, but the left upper lobe bronchus arose from the anterior wall of the main bronchus. There was a moderate amount of mucopus in the segmental branches of the lower lobe. The right main bronchus was -in. long and terminated as a transverse pocket. No sign of an opening beyond this could be demonstrated.Bronchograms (Figs. 2, 3, 4) were performed and revealed a moderate stenosis of the origin of the left main bronchus and a short, completely closed pocket which represented the right main bronchus. The left upper lobe had swung across to fill the right chest and the left apical lower fill...

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Section: Discussionmentioning

confidence: 99%

Six Cases of Traumatic Rupture of the Bronchus

Bates¹,

Beard²

1956

Thorax

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“…Such procedures often involve excision of a diseased segment of main bronchus, and subsequent endto-end anastomosis. When there is distal healthy lung, old healed tuberculous bronchostenosis has been treated in this way (Jackson, Jones, and Holmes Sellors, 1955). Similarly, lobectomy with resection of a " sleeve " of main bronchus has been used in removing advanced upper lobe bronchial carcinoma (Price Thomas, 1956; Johnston and Jones, 1959 Normally the harmful effects of a pulmonary vascular shunt through unventilated lung are most noticeable while the chest is being opened and before the lung has been allowed to deflate.…”

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confidence: 99%