Rotura traqueal postintubación tratada con prótesis en Y de Dumon / Post-tracheal intubation rupture treated with a Dumon-Y Stent

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Mitomicina C tópica endotraqueal como terapia complementaria al tratamiento endoscópico de la estenosis laringotraqueal fibrótico-cicatricial recurrente / Topical endotracheal mitomycin C as a complementary treatment for endoscopic treatment of recurrent laryngotracheal stenosis

Objetivo Describir la preparación de mitomicina C tópica endotraqueal y los resultados clínicos de 4 pacientes tratados de forma coadyuvante con mitomicina C tópica para estenosis laringotraqueales (ELT) graves y recurrentes. Método Revisión bibliográfica para determinar la concentración y forma de elaboración de mitomicina C para uso tópico endotraqueal. Revisión de las historias clínicas. Resultados Se determina una concentración de 0,4mg/ml mitomicina C tópica en el tratamiento de las estenosis laringotraqueales. En los casos tratados se aplicó la solución de 0,4mg/ml en la zona estenosada tras fotorresección con láser y dilatación con broncoscopio. Tres pacientes se encuentran asintomáticos desde el punto de vista respiratorio y en uno, ha fracasado el tratamiento. Conclusiones El tratamiento ELT es complejo debido al continuo desarrollo de tejido de granulación y fibrosis como consecuencia de lesiones de la vía aérea. La mitomicina C tópica, por sus potentes efectos antifibróticos, parece ser el agente coadyuvante idóneo (AU)

Objective To describe the preparation of topical endotracheal mitomycin C and the clinical outcomes of four patients with recurrent and severe laryngotracheal stenosis (LTS) treated with adjuvant topical mitomycin C. Method Literature review to determine the concentration and method of preparation of topical mitomycin C for endotracheal use. Review of clinical histories. Results We established a concentration of 0.4mg/ml topical mitomycin C for the treatment of laryngotracheal stenosis. In the treated cases, we applied a 0.4mg/ml solution to the wound site following laser surgery and dilatation with bronchoscope. Three patients remain asymptomatic from a respiratory perspective, and treatment failed in one case. Conclusions LTS treatment is complex due to the continuous development of granulation tissue and fibrosis following injury to the airways. Topical mitomycin C seems to be the ideal adjuvant agent thanks to its powerful antifibrotic effects (AU)

Topical endotracheal mitomycin C as a complementary treatment for endoscopic treatment of recurrent laryngotracheal stenosis.

OBJECTIVE: To describe the preparation of topical endotracheal mitomycin C and the clinical outcomes of four patients with recurrent and severe laryngotracheal stenosis (LTS) treated with adjuvant topical mitomycin C. METHOD: Literature review to determine the concentration and method of preparation of topical mitomycin C for endotracheal use. Review of clinical histories. RESULTS: We established a concentration of 0.4 mg/ml topical mitomycin C for the treatment of laryngotracheal stenosis. In the treated cases, we applied a 0.4 mg/ml solution to the wound site following laser surgery and dilatation with bronchoscope. Three patients remain asymptomatic from a respiratory perspective, and treatment failed in one case. CONCLUSIONS: LTS treatment is complex due to the continuous development of granulation tissue and fibrosis following injury to the airways. Topical mitomycin C seems to be the ideal adjuvant agent thanks to its powerful antifibrotic effects.

Reacción aguda de cuerpo extraño tras colocación de endoprótesis traqueobronquial en “Y” de Dumon / No disponible

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El lóbulo de la vena ácigos / No disponible

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Técnicas pleurales: toracocentesis. Biopsia pleural con aguja. Drenaje pleural con sonda / No disponible

La toracocentesis diagnóstica, la biopsia pleural y la colocación de tubos de drenaje son técnicas habituales en Neumología, que bien indicadas y realizadas son de gran valor para el diagnóstico y tratamiento de determinadas patologías neumológicas. Se realiza una revisión de las indicaciones, contraindicaciones, complicaciones y técnica de realización de todas ellas, haciendo hincapié fundamentalmente en sus aspectos prácticos (AU)

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[Bronchiolitis obliterans with organized pneumonia associated with measles virus]. / Bronquiolitis obliterante con neumonía organizada relacionada con virus del sarampión.

Bronchiolitis obliterans with organizing pneumonia (BOOP) is a nonspecific form of pulmonary injury related to different etiologic agents. The disorder is not only limited to the alveoli but also affects to the alveolar ducts and distal bronchioles. This fact may differentiate this disorder of others with chronic inflammatory diffuse alveolar lesion as chronic eosinophilic pneumonia (CEP), extrinsic allergic alveolitis (EAA) or diffuse alveolar damage (DAD). It has been described an idiopathic form and other associated with connective tissue diseases, infections, organ's transplantation, drug or chemical induced reactions, irradiation pneumonitis and aspiration pneumonitis, among others. Their extremely variable clinical presentation and course, etiology, and histologic appearance and, in some way, the considerable confusion as a result to the different terminologies applied, has made difficult a clear understanding of this disease. We present two cases of BOOP related to infection by measles virus, whose diagnostic was obtained through pulmonary thoracoscopic biopsy and serological study respectively. Patients were treated with steroids (6 months) with a favorable outcome in terms of clinical symptoms, radiological findings, and a normalization of the pulmonary function tests. We suggest that in each patient with clinic and radiological study suspicious of BOOP, it seem to be useful to include measles virus in serologic study. This investigation may contribute to reduce the number of cases classified as idiopathic BOOP.