A case of congenital bronchial atresia with tracheobronchial stenosis caused by emphysema: Successful management with thoracoscopic surgery
Huan Lin,
Sen Tian,
Chunlai Niu,
Xiaping Shen,
Mingming Wang,
Changhong Wan,
Bowen Shi,
Hezhong Chen,
Miaoxia He,
Chong Bai,
Haidong Huang
Affiliations
Huan Lin
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China
Sen Tian
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China; Department of Respiratory and Critical Care Medicine, No. 906 Hospital of the Chinese People's Liberation Army Joint Logistic Support Force, Ningbo, China
Chunlai Niu
Department of Rehabilitation Medicine, The Second Rehabilitation Hospital of Shanghai, Shanghai, China
Xiaping Shen
Department of Radiology, The First Affiliated Hospital of Naval Medical University, Shanghai, China
Mingming Wang
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China; Department of Respiratory and Critical Care Medicine, The Second People's Hospital of Fuyang City, Fuyang, Anhui, China
Changhong Wan
Department of Chest, Lung and Breast Surgery, Clifford Hospital, Guangzhou, Guangdong, China
Bowen Shi
Department of Thoracic Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, China
Hezhong Chen
Department of Thoracic Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, China
Miaoxia He
Department of Pathology, The First Affiliated Hospital of Naval Medical University, Shanghai, China
Chong Bai
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China; Corresponding author.
Haidong Huang
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China; Corresponding author.
Introduction: Congenital bronchial atresia (CBA), as a rare developmental abnormality of the lung, is usually asymptomatic and is accidently discovered in most cases. Currently, no standardized guidelines for the treatment or management of CBA have been established. Case presentation: A 22-year-old male soldier was referred to Shanghai Changhai Hospital, The First Affiliated Hospital of Naval Medical University due to chest tightness and shortness of breath after repeated strenuous activities. Contrast-enhanced computed tomography (CT) revealed an 18mm × 11mm solitary, well-circumscribed, and solid nodule with no enhancement in the right upper lobe (RUL), and emphysematous changes distributed throughout the RUL. A flexible bronchoscopic examination showed extrinsic compression stenosis in the bronchial opening of the right middle lobe (RML). After three-dimensional (3D) reconstruction CT and a multidisciplinary consultation, a diagnosis of CBA in the anterior segment (B3) of RUL was established. Subsequently, thoracoscopic right upper lobectomy was performed and resulted in an improved respiratory capacity 6 months after surgery. To date, the patient has good quality of life without any complication. Conclusion: This study underscores the role of bronchoscopy, 3D reconstruction CT, and a multidisciplinary consultation in the diagnosis of CBA, and highlights that a thoracoscopic intervention should be considered in such case.
