Lymphangiomatosis presenting with bronchial cast formation.

Lymphangiomatosis is a rare disorder of the lymphatic system that is known to cause chylothorax. Chyloptysis may occur but chylous bronchial cast formation is rare. A case is reported of lymphangiomatosis in a 34 year old woman whose initial manifestation was cough productive of bronchial casts. Two years later the patient developed a chylothorax. Ligation of the thoracic duct through a low thoracotomy was curative.

Successful retrieval of fractured tracheostomy cannula by flexible fiberoptic bronchoscopy.

The fracture and aspiration of tracheostomy tubing is not rare. It may go unnoticed by the patient. The equipment is prone to shearing at the flange and fracture along its body. Its integrity should be routinely tested, and a policy instituted for the discarding of old equipment. Fiberoptic bronchoscopy is advantageous in that it can be performed quickly and easily, it avoids general anesthesia, and it is more adaptable to foreign body retrieval than the nasopharyngoscope because of its forceps channel, through which varied retrieval instruments can be passed.