Abstract
The patient was a 19-year-old man who received antituberculous drugs for pulmonary tuberculosis from August 1993. One year later, the patient developed dyspnea, and chest X-ray showed complete atelectasis of the left lung secondary to bronchial tuberculosis diagnosed by bronchial biopsy. Bronchofiberscopy after admission to our hospital showed reddening and edema of the mucosa of the left main bronchus and occlusion three cartilage rings distal to the tracheal carina. We first used a 5Fr Fogarty balloon catheter to dilatate the site of occlusion under bronchoscopic guidance. The left main bronchus was successfully dilatated to a diameter of about 5 mm and the left lower lobe was re-expanded. 3D-CT revealed occlusion of the left upper lobe bronchus and patency of the lower lobe bronchus. One week later, the stenotic site was dilatated to a diameter of about 8 mm using a 5Fr PTCA catheter, and 2 weeks later, dilatated to a diameter of about 1 cm using a 9Fr Sengstaken-Blakemore tube with the balloon left in place for 1 day. 3D-CT showed the left main bronchus to have a diameter of about 8 mm. In this case, a stepwise balloon dilatation method was effective in relieving airway occlusion secondary to bronchial tuberculosis and 3D-CT was useful for evaluating the extent of stenosis.
