ABSTRACT
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Subject(s)
Humans , History, 20th Century , Societies, Medical/history , Pleural Diseases/diagnosis , Pulmonary Medicine/history , Bronchoscopy , Pulmonary Medicine/organization & administration , Pulmonary Medicine/standards , SpainABSTRACT
El cáncer de esófago es la principal causa de fístula traqueoesofágica (FTE). Es una complicación habitualmente asociada al tratamiento quimio-radioterápico producida por necrosis tumoral. La presencia de una FTE ensombrece el pronóstico, pudiendo provocar infecciones respiratorias, sepsis y fallecimiento. El tratamiento quirúrgico no suele ser posible en estos casos, debido a la enfermedad oncológica avanzada y a la mala situación general de estos pacientes. El tratamiento endoscópico supone una alternativa terapéutica paliativa con el fin de aliviar la sintomatología y aislar las vías aérea y digestiva. Este abordaje no está exento de complicaciones, algunas precoces, como la migración de la prótesis como el caso de la paciente que presentamos a continuación. Se presenta el caso de una mujer de 63 años, diagnosticada de carcinoma epidermoide de esófago tratado mediante esofaguectomía, plastia gástrica y quimiorradioterapia adyuvante. Un año tras el diagnóstico se objetiva una FTE, implantándose una prótesis esofágica y traqueal
Esophageal malignancy is the main cause of tracheoesophageal fistula (TEF). TEF usually develops during or after completing radiation and chemotherapy with subsequent tumor necrosis. It is a complication that can be associated with a poor prognosis due to associated complications such as respiratory infections, sepsis and death. As surgical intervention is often not an advisable option due to advanced malignancy and poor performance status of the patients, bronchoscopic intervention provides a good choice to palliate symptoms and isolate the trachea from the esophagus. However, early complications such as stent displacement may occur, as in the case presented below. We report the case of a 63-year-old patient, who was diagnosed with a squamous-cell esophageal cancer previously treated with esophagectomy, gastric plasty and adjuvant chemoradiotherapy. One year later, a TEF was found, so a tracheal and esophageal stent was inserted
Subject(s)
Humans , Female , Middle Aged , Esophageal Neoplasms/complications , Carcinoma, Squamous Cell/complications , Tracheoesophageal Fistula/diagnosis , Tracheoesophageal Fistula/etiology , Tracheoesophageal Fistula/surgery , Fatal Outcome , Endoscopy , StentsABSTRACT
En pacientes con enfisema pulmonar, la reducción del volumen pulmonar endoscópica (RVPE) es una terapia válida en estadios avanzados y que puede mejorar la tolerancia al ejercicio, la calidad de vida y la función respiratoria en pacientes seleccionados. Presentamos el caso de un paciente con enfermedad pulmonar obstructiva crónica tipo enfisematoso, quien a pesar de tratamiento farmacológico óptimo evoluciona a empeoramiento de su clase funcional, por lo que se consideró candidato a técnicas de RVPE, tras comprobar que cumplía criterios. El paciente precisó la realización de dos técnicas endoscópicas secuenciadas, primero mediante colocación de válvulas y en una segunda fase de coils, que finalmente permitieron la estabilización de la enfermedad a la espera del trasplante pulmonar
Endoscopic lung volume reduction (ELVR) is an accepted treatment option for patients with advanced emphysema and it has been demonstrated to improve exercise tolerance, pulmonary function, and quality of life in selected patients. We present the case of a patient with chronic obstructive pulmonary disease who, despite optimal pharmacological treatment, persisted with worsening of his functional class, which is why he was considered a candidate for endoscopic lung volume reduction techniques, after ascertaining that he met inclusion criteria. The patient needed to undergo two endoscopic techniques due to the suspicion of ineffectiveness of one of them, which finally allowed the stabilization of the disease while awaiting to receive lung transplantation
Subject(s)
Humans , Male , Middle Aged , Pulmonary Disease, Chronic Obstructive/surgery , Pneumonectomy/methods , Pulmonary Valve , EndoscopyABSTRACT
Las lesiones bronquiales preinvasivas se detectan con escasa frecuencia mediante broncofibroscopia convencional y su manejo posterior sigue planteando numerosas cuestiones en cuanto a la periodicidad y tiempo de seguimiento, así como la necesidad de empleo de broncofibroscopia con fluorescencia y realización de terapia endobronquial. Se presenta el caso de un varón diagnosticado de displasia bronquial moderada mediante broncofibroscopia convencional de luz blanca
reinvasive bronchial lesions are detected infrequently by conventional bronchoscopy. Further management still poses many questions about the frequency, time tracking, and the need for use of fluorescence bronchoscopy and endobronchial therapy. We report the case of a man diagnosed with moderate bronchial dysplasia by conventional bronchoscop
Subject(s)
Humans , Male , Bronchial Diseases/diagnosis , Bronchoscopy/methods , Bronchopulmonary Dysplasia/diagnosis , Spectrometry, Fluorescence/methodsABSTRACT
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Subject(s)
Humans , Bronchoalveolar Lavage/methods , Bronchoscopy/methods , Pneumonia, Ventilator-Associated/microbiology , Opportunistic Infections/microbiology , Lung Diseases, Fungal/microbiologyABSTRACT
Endobronchial granulomas in children are mainly caused by mycobacterial infections. In addition to Mycobacterium tuberculosis, other organisms such as nontuberculous mycobacteria (NTM) have emerged. These organisms cause a broad spectrum of pulmonary diseases. An isolated endobronchial NTM infection in a child is reported. After bronchoscopic removal, a decision not to add drug treatment was made, with satisfactory results. Treatment options are not well established in children and remain a source of controversy. Different options are discussed.
Subject(s)
Bronchial Diseases/surgery , Bronchoscopy , Granuloma/surgery , Immunocompetence , Mycobacterium Infections, Nontuberculous/surgery , Mycobacterium avium Complex/isolation & purification , Bronchial Diseases/diagnostic imaging , Bronchial Diseases/microbiology , Granuloma/diagnostic imaging , Granuloma/microbiology , Humans , Infant , Male , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium Infections, Nontuberculous/diagnostic imaging , RadiographyABSTRACT
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Subject(s)
Humans , Bronchoscopy/methods , Practice Patterns, Physicians' , Conscious Sedation , Hypnotics and Sedatives/administration & dosage , Informed Consent/standards , Oximetry , Monitoring, PhysiologicABSTRACT
Lymphangioleiomyomatosis is an unusual disease characterized by atypical smooth muscle hyperplasia especially of the lymphatic system and affecting females in their child-bearing years. We present a case in which ovarian function was annuled through radiotherapy, instead of resorting to the most commonly used oophorectomy, since the patient's severe respiratory dysfunction made surgery inadvisable. The clinical, radiological and functional characteristics of this entity are discussed, and the therapeutic possibilities are reviewed.
