Tracheobronchomalacia as a Rare Cause of Chronic Dyspnea in Adults

Abstract

Objective: To emphasize the importance of a careful clinical evaluation to prevent unnecessary interventions and treatments. Clinical Presentation and Intervention: A 76-year-old female patient had been diagnosed with asthma during previous admissions to different hospitals. She had also undergone fiberoptic bronchoscopy (FOB) on 2 occasions for evaluation of right middle lobe atelectasis observed on computed tomography. A repeated FOB revealed tracheobronchomalacia and nodular bronchial amyloidosis. A silicone Y stent was inserted, but the dyspnea increased. Excessive granulation tissue developed, and the patient died despite ventilatory support. Conclusion: The stenting technique used did not prevent the development of respiratory failure and death in this patient. Hence, a surgical procedure could be considered as an alternative to stenting in such cases.

Bronchial Anthracofibrosis and Tracheobronchomalacia

“…However, the factors associated with the development of this disease are not thoroughly known. [9][10][11] The weakness of the walls of trachea and bronchi can lead to dynamic obstruction of the respiratory tract. It can also cause severe conditions such as expiratory stridor, severe cough, inhaled bronchodilator and corticosteroid-resistant wheezing, recurrent lower respiratory tract infections, and respiratory failure.…”

“…12 The symptoms of this illness are nonexclusive, and are often misinterpreted as treatment-resistant asthma, leading to an increase in complications of treatment in patients. 10 Eventually, 7% of patients with the severe and diffuse type of this disease might need mechanical ventilation due to respiratory failure. 12 Stridor and hypoxia emerge in severe cases, leading to an 80% mortality rate if left untreated.…”

A 31-year-old female with a rare cause of recurrent lower lobar collapses

“…It can be classified as congenital, occurring during infancy which may be an isolated finding, or may be acquired during adulthood due to damage to the bronchial tree. Such insults include chronic infection, tuberculosis, trauma, chronic bronchitis, post-intubation, thoracic malignancies and amyloidosis [ 1 , 3 , 4 ].…”