Unilateral post-tuberculous lung destruction: the left bronchus syndrome.

Abstract

In a prospective study of 13 patients requiring pneumonectomy for unilateral post-tuberculous lung destruction the left side was found to be affected in 12. Review of a further 172 cases showed the left lung to have been destroyed in 109 (63%). It is suggested that this predominance of the left side is due to the anatomical characteristics of the left main bronchus and that disordered haemodynamics also appear to play a part.Unilateral total post-tuberculous lung destruction is a well recognised cause ofmorbidity and mortality.' 2 In Saudi Arabia late presentation and poor compliance with treatment for tuberculosis (as low as 30%') account for an appreciable number of patients presenting in this way, but very few studies have dealt with the problem in detail.4 We report the clinicopathological and haemodynamic findings in 13 patients coming to surgery at King Khalid University Hospital. The left lung was affected more frequently than the right, and we discuss the reasons for this predilection. Patients and methodsWe studied 13 patients with unilateral lung destruction before elective pneumonectomy, by bronchoscopy, bronchography, pulmonary angiography, thoracic aortography, ven-

The anatomy of left bronchus syndrome

“…An earlier report (Ashour et al, 1990) revealed that unilateral lung destruction occurred in 10.9% of 1,600 patients with pulmonary tuberculosis in Saudi Arabia. Left sided lung destruction was seen in 64% of those patients.…”

Multidrug Resistant Pulmonary Tuberculosis a Clinical Profile of 28 Cases

“…The prevalence of NIDDM was also found to be higher than that in the general population reflecting a role of the immune system in clearance of infection [8]. The commoner occurrence of destroyed lung on the left side has been commented on by other workers, and thought to be caused by the poorer drainage created by the hori- zontal left bronchus [9]. Lung destruction was seen even in those patients who had disease for relatively short periods of time perhaps reflecting excessive hypersensitivity.…”

Tuberculous damaged lung in a child

“…Bateson in 1976 used the term “destroyed lung” to describe the disease in West Indians and Australian aboriginals 5. TDL occurred almost always in the left lung 7–9, 11, 12…”

“…TDL usually occurs as a post‐primary tuberculosis process. The combination of lymph stasis, reduced to absent pulmonary artery flow from bronchial obstruction and infection contribute to the spread of TB infection and eventual lung destruction 12…”