Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-05T06:37:18.822Z Has data issue: false hasContentIssue false

Have we got the full picture?

Published online by Cambridge University Press:  29 June 2007

R. Demajumdar*
Affiliation:
Department of OtolaryngologyHeartlands Hospital, Birmingham, UK.
P. B. Rajesh
Affiliation:
Department of Cardiothoracic Surgery, Heartlands Hospital, Birmingham, UK.
*
Address for correspondence: R. Demajumdar, 9 The Green, Oldbury, Warley, West Midlands B68 8DU.

Abstract

A 59-year-old man with long-standing chronic obstructive airways disease (COPD), became progressively dyspnoeic, and repeatedly blacked-out during forced expiration. Spirometry suggested the possibility of large airways obstruction, and failing to respond to aggressive bronchodilator and steroid therapy, the patient was labelled as being non-compliant. Finally, he was assessed by an otolaryngologist and a cause for upper airway obstruction was suspected. Bronchoscopy and computed tomography (CT) scanning demonstrated tracheomalacia and the patient underwent resection of this segment of abnormal trachea.

Tracheomalacia, although rare, results from the substitution of cartilage with fibrous tissue, leading to severe airway compromise.

This case emphasizes the fact that although many conditions are uncommon, the total incidence of rare conditions is surprisingly high, and that care needs to be taken at all times in the management of ‘labelled’ patients with chronic illness, in order not to overlook such life-threatening diagnoses.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Duncan, S., Eid, N. (1991) Tracheomalacia and bronchopulmonary dysplasia. Annals of Otology, Rhinology and Laryngology 100(10): 856858.CrossRefGoogle ScholarPubMed
Feist, J. H., Johnson, T. H., Wilson, R. J. (1975) Acquired tracheomalacia: aetiology and differential diagnosis. Chest 68(3): 340345.CrossRefGoogle ScholarPubMed
Hoskins, M. C., Evans, R. A., King, S. J., Gishen, P. (1991) ‘lSabre sheath’ trachea with mediastinal lipomatosis mimicking a mediastinal tumour. Clinical Radiology 44(6): 417418.CrossRefGoogle ScholarPubMed
Johnson, T. H., Mikita, J. J., Wilson, R. J., Feist, J. H. (1973) Acquired tracheomalacia. Radiology 109: 577580.CrossRefGoogle ScholarPubMed
Kang, F. C., Tsai, Y. C., Jiang, C. Y., Chan, H. P., Chang, C. L. (1996) Acquired tracheomalacia – a case report. Acta Anaesthesiologica Sinica 34(4): 239242.Google ScholarPubMed
Stern, E. J., Graham, C. M., Webb, W. R., Gamsu, G. (1993) Normal trachea during forced expiration: Dynamic CT measurements. Radiology 187: 2731.CrossRefGoogle ScholarPubMed