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Tracheobronchial Tree (tracheobronchial + tree)
Selected AbstractsImaging in bronchopulmonary sequestrationJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 1 2009P Abbey Summary Bronchopulmonary sequestration is an uncommon pulmonary disorder characterized by an area of non-functioning abnormal lung tissue, which receives its blood supply from a systemic artery and characteristically has no connection with the tracheobronchial tree. The abnormal lung tissue is located within the visceral pleura of a pulmonary lobe in the intralobar variety, whereas the extralobar form has its own visceral pleura. The venous drainage of the extralobar type is usually into the systemic veins, whereas the intralobar type drains into the pulmonary veins. Radiological imaging plays a vital role in establishing the diagnosis, and even more importantly, in providing to the clinician a vascular roadmap essential for surgical planning. We present here a review of bronchopulmonary sequestration and also discuss the role of various imaging methods in the early diagnosis and management of these cases. [source] Malpositioning of fine bore feeding tube: A serious complicationACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2005R. Kawati Feeding tubes are used frequently in the intensive care unit to provide enteral nutrition. For critically ill patients, enteral nutrition is preferable to parenteral in terms of cost, complication and gut mucosal maintenance. Fine bore feeding tubes are always preferred because their soft, flexible construction and narrow diameter enables these tubes to be well tolerated by patients and they rarely contribute to sinus infections or obstruction of breathing. On the other hand it is not uncommon that these tubes are misplaced in the tracheobronchial tree or the pleural cavity, especially in high-risk patients, i.e. sedated patients, patients with weak cough reflex, endotracheally intubated patients and agitated patients (1,3). Malpositioning in the peritoneal cavity or the mediastinum through gastric or esophageal perforation is also possible (1, 4,7); even intravascular (8, 9) and intracranial misplacement have been reported (10,13). The incidence of misplacement of a feeding tube is difficult to estimate because few studies have been performed. The largest study of 1100 such tubes revealed an overall malposition rate of 1.3% (1), but it should be mentioned that this study included only radiographically detected misplacements. Other researchers estimate the occurrence of accidental misplacement and migration out of position as high as 13% to 20% in high-risk patients (14, 15). [source] Anaesthetic management of tracheobronchial rupture following blunt chest traumaACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2003K. Naghibi Injuries to the tracheobronchial tree are a well-recognized sequel of massive blunt trauma to the chest, and although unusual, are life threatening. We report a 16-year-old-boy who developed complete disruption of both bronchi after a motor vehicle accident. After induction of general anaesthesia and oral intubation, ventilation could not be maintained, and oxygenation worsened abruptly with peripheral oxygen saturation values less than 60%. Jet ventilation through two intrabronchial catheters, inserted via emergency thoracotomy, raised the saturation from 60% to 100%, and surgery thereafter was straightforward. The anaesthetic management of tracheobronchial repair is discussed. [source] Pulmonary hemorrhage/hemoptysis in childrenPEDIATRIC PULMONOLOGY, Issue 6 2004Simon Godfrey MD Abstract Pulmonary hemorrhage and hemoptysis are uncommon in childhood, and the frequency with which they are encountered by the pediatric pulmonologist depends largely on the special interests of the center to which the child is referred. In those centers caring for children with cystic fibrosis or congenital heart disease, these will be by far the most common causes of hemoptysis. Other causes of hemoptysis are far less common, such as bleeding from localized lesions in the upper airway or tracheobronchial tree. Even less common is bleeding into the lungs as part of a systemic disease, usually with renal involvement (pulmonary-renal syndromes), such as systemic lupus erythematosis or Goodpasture's syndrome. Bleeding into the lungs in children with a bleeding diathesis probably only occurs in immunosuppressed children after transplantation. When no other cause is found for pulmonary hemorrhage, the presumed diagnosis is idiopathic pulmonary hemosiderosis. This review discusses the various causes of hemoptysis and pulmonary hemorrhage, and the appropriate investigations to aid in determining the correct diagnosis. The management and prognosis of idiopathic pulmonary hemosiderosis, based on cumulative experience from published reports, are considered in more detail. Pediatr Pulmonol. 2004; 37:476,484. © 2004 Wiley-Liss, Inc. [source] Prognostic factors of tracheobronchial mucoepidermoid carcinoma,15 years experienceRESPIROLOGY, Issue 2 2008Chien-Hung CHIN Background and objectives: Mucoepidermoid carcinoma of the tracheobronchial tree is a rare tumour which displays a variable degree of clinical aggressiveness and malignancy. The relationship between the patient's prognosis and the tumour's histological features and clinical behaviour is uncertain. The aim of this study was to identify the clinicopathological features and analyse the outcomes of patients with this type of cancer. Methods: A retrospective analysis of the medical records of patients diagnosed with mucoepidermoid carcinoma of the lung between 1991 and 2006 was conducted. Results: The study comprised 15 patients. Higher histological grade tumours had a higher proportion of squamoid cells (P = 0.019); the tumours of patients with lymph node metastases also had a higher proportion of squamoid cells than did the tumours of patients without lymph node metastases (P = 0.015). Patients with early stage tumours (stage IA, IB, IIB) had better outcomes (10-year survival rate = 87.5%), than did patients with late-stage tumours (stage IIIB, IV) (1-year survival rate = 28.6%; 2-year survival rate = 0%, P = 0.001). Patients with lower-grade tumours (grade 1 and grade 2) had better outcomes (1-year survival rate = 80%; 5-year survival rate = 57.1%) than did patients with higher-grade tumours (grade 3) (1-year survival rate = 20%, P = 0.035). Tumour staging was a significant independent predictor of survival on Cox proportional hazards analysis. Conclusions: The proportion of squamoid cells on tumour histology may be an indicator of the level of tumour malignancy. Tumour, node, metastasis staging is a significant determinant of prognosis in patients with tracheobronchial mucoepidermoid carcinoma. [source] Morphological Analysis of the Lung of Neonatal YakANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 2 2010B. Yang Summary With 20 figures and 5 tables Although yaks play an important role as companion or pack and draught animals on Chinese plateaus in alpine and sub-alpine regions, morphological studies and anatomical data on the lung of yak are sparse. To provide anatomical descriptions and morphometric data, 10 one-day-old yaks were examined by means of dissection, light and electron microscopy. The measurements of lung were made on dissected specimens and histological sections. Unequal dichotomous branching was demonstrated in the dissected tracheobronchial tree. The diameters of bronchial airways and height of epithelium were measured, and showed that the variation of diameters in airways was always greater than that of height of epithelium. In addition, the thickness of muscularis, cartilage and adventitia was examined, as well as the number of goblet and Clara cells in airways. Ultrastructural studies showed that the surface epithelium was mainly composed of goblet, ciliated, Clara and basal cells, similar to that in other domestic animals. Under electron microscope, two distinctive types of ciliated cells could be seen in the tracheobronchial epithelium. The first type contained some mitochondria, distended smooth endoplasmic reticulum (SER), little rough endoplasmic reticulum (RER) and numerous vacuoles in electron-lucent cytoplasm. The second type had dense cytoplasm with abundant mitochondria, RER and no vacuoles. Both types were rich of glycogen granules. The goblet cells in neonatal yak lung had the following characteristic features: dentate nucleus in dense cytoplasm, with stacks of RER and numerous dense membrane-bounded mucous droplets, which were round or oval, often with an electron-lucent core. The droplets were not confluent. Glycogen granules were numerous, and Golgi complex was occasionally present. Clara cells were dome-shaped and usually protruded into the airway lumen. Large amounts of SER and many secretory droplets were found within the cytoplasm. Several typical ,clefts' were also found in the cytoplasm. [source] Blood clot cast of the tracheobronchial treeANZ JOURNAL OF SURGERY, Issue 6 2010Luc G. T. Morris MD No abstract is available for this article. [source] Utility of multidetector CT and virtual bronchoscopy in tracheobronchial obstruction in childrenACTA PAEDIATRICA, Issue 7 2010Kushaljit Singh Sodhi Abstract Purpose:, The aim of this study was to evaluate the potential use of multidetector CT (MDCT) and virtual bronchoscopy (VB) in the evaluation of tracheobronchial patency in children with suspected bronchial obstruction and to compare its findings with fibreoptic/rigid bronchoscopy or surgery. Patients and methods:, A total of 43 children (15 girls, 28 boys) with clinically suspected bronchial obstruction underwent contrast enhanced MDCT, using an age- and weight- adjusted low dose protocol. Post-processing was performed and VB and multiplanar reformations (MPR) were obtained at the same sitting. Findings obtained at MDCT and VB were compared with fibreoptic/rigid bronchoscopy and surgery. Results:, Obstructive pathology was found in 26 children, which included endoluminal foreign body, mucus plugs in 13 children, endobronchial tumour in three children and extrinsic compression (lymph node, aberrant Vessels, mediastinal cysts/tumours) of the tracheobronchial tree in 10 children. In 17 children, no obstructive lesion was identified. Excellent positive correlation was obtained, between MDCT-VB and bronchoscopy/surgery, however, in one child with endobronchial obstruction caused by tracheitis, low dose MDCT-VB was normal, but bronchoscopy revealed granularity and plaques. Conclusion:, MDCT-Virtual bronchoscopy is useful in evaluating bronchial stenosis and obstruction caused by both endoluminal pathology and external compression and has the advantage of looking beyond stenosis. Its main application lies in providing the exact location of suspected foreign body, prior to bronchoscopy. However, it fails to disclose exact nature of obstructing pathology. [source] Isolated invasive Aspergillus tracheobronchitis: a clinical study of 19 casesCLINICAL MICROBIOLOGY AND INFECTION, Issue 6 2010N. Wu Clin Microbiol Infect 2010; 16: 689,695 Abstract Isolated invasive Aspergillus tracheobronchitis (iIATB) is an uncommon clinical form of invasive Aspergillosis in which Aspergillus infection is limited entirely or predominantly to the tracheobronchial tree. In the present study, we retrospectively analyzed the medical records of 19 patients who had histological documented iIATB in the Department of Respiratory Medicine of Changhai Hospital between October 2000 and February 2008. Malignancy was the most common underlying disease, which existed in 14 patients (73.7%) in our series. Most patients had impaired airway structures or defence functions, whereas the systemic immune status was relatively normal. Only three patients (15.8%) had neutropenia. The clinical manifestations and chest radiograph were nonspecific. We classified iIATB into four different forms according to the bronchoscopic features of intraluminal lesions: superficial infiltration type (Type I, n = 4), full-layer involvement type (Type II, n = 2), occlusion type (Type III, n = 6) and mixed type (Type IV, n = 7). Type IV was the largest group in our study, followed by Type III. All patients with iIATB of Type IV had definite airway occlusion. Fourteen patients (73.7%) had a good response to antifungal treatments and five (26.3%) died as a result of the progression of Aspergillosis, all of whom had full-layer invasion of the involved bronchi. In conclusion, we found that iIATB could occur in moderately or non-immunocompromised patients with impaired airway structures or defence functions and may be an early period of invasive pulmonary Aspergillosis. Most of the iIATB patients had a favourable prognosis with early diagnosis and effective antifungal treatment. The morphological features of intraluminal lesions might be of prognostic value. [source] | ||||||||||