2013 Volume 35 Issue 3 Pages 259-264
Background. Tracheobronchomalacia cause functional tracheal/bronchial stenosis. However, recently, a new criterion, excessive dynamic airway collapse (EDAC), has been proposed. There are still few reports on EDAC. Case. A 50-year-old woman could not move due to dyspnea, and was brought to our hospital by ambulance. Abdominal computed tomography (CT) revealed a giant ovarian tumor. This tumor was considered to be an etiological factor for respiratory failure and ventilation disorder. Emergency surgery was performed. As weaning from the ventilator was difficult after surgery, bronchoscopy was conducted. The tracheal mucosa was normal, but the trachea showed crescent-like stenosis. Complete occlusion was observed on coughing. There were no changes in the tracheal cartilage area, and the membranous area relaxation on expiration was adjacent to the anterior wall of the trachea, leading to a diagnosis of EDAC. While maintaining the PEEP at 8 cm H_2O, artificial respiration was switched to CPAP therapy with non-invasive positive pressure ventilation to achieve weaning from the ventilator. The respiratory state stabilized. Conclusion. When withdrawal from control with a ventilator is difficult, bronchoscopy should be performed, considering the possibility of EDAC.