| Clinical Observation of Endobronchial Tuberculosis |
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Sung Kwang Kim, Sung Jin Kim, Dong Ill Ahn, Nam Soo Rhu, Dong Ill Cho, Jae Won Kim |
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Department of Chest Medicine, National Medical Center |
| 기관 및 기관지결핵에 대한 임상적 관찰 |
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김성광, 김성진, 안동일, 유남수, 조동일, 김재원 |
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| Abstract |
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Twenty-six cases of bronchial stenosis due to tuberculosis were found during three years at the department of chest medicine, National Medical Center in Korea. Twenty cases were in young people aged below 30 years and predominatly female (12: 1). The symptoms were mostly cough, dyspnea and tenacious sputum. Physical examination revealed localized wheezing and rale, which hardly differentiated from malignancy in some cases. Primary plain chest X-ray showed one normal finding and others had pulmonary infiltration or collapse with emphysema in variable degrees. Diagnosis was confirmed by finding of tubercle bacilli or histologic examination through bronchoscopic examination and stenotic degrees
πere seen mostly by bronchography. The proximal stenotic portion in individuals were noted as follows: four cases of lower part of trachea, six cases of main bronchus, thirteen cases of lobar bronchus two cases of intermedius bronchus and one case of segmental bronchi. Prognosis of stenosis after medical treatment such as repeated bronchoscopic aspiration, intermittent positive pressure breathing with mucolytics and intensive antituberculosis chemotherapy showed as below; two cases returned to normal bronchus, ten cases were noted slightly or moderately improved, four cases were noted as no change and five cεses
had further developed stenotic change to the more proximal part.
Five cases were improved by operation as follow; four cases of unilateral pneumonectomy, one case of paratracheal lymphnode resection and resection of stenotic portion ￦ith end to end anastomosis.. When young people have abnormal wheezing and rale or collapse and atelectatic change with emphysema on chest X-ray, the possibility of endobronchial tuberculosis should borne in mind. especially in country of high prevalence of tuberculosis like Korea, for early detection and starting of early intensive treatment for prevention of permanent bronchial stenosis. |
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