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Lung resections in bronchiectasis due to lipoid pneumonia: a custom-design approach
1Department of Surgery, College of Medicine, King Khalid University, and Asir Central Hospital, Abha, Kingdom of Saudi Arabia.
Insights
Surgical lung resection effectively treated bronchiectasis in children caused by ghee aspiration. Most symptoms resolved post-surgery, with no immediate deaths, though long-term outcomes varied.
Area of Science:
- Pediatric Surgery
- Pulmonology
- Medical Case Study
Background:
- Bronchiectasis in children can result from aspiration of substances like animal fat (ghee).
- Lipoid pneumonia from ghee aspiration can lead to severe, treatment-resistant bronchiectasis.
- Surgical intervention is considered for refractory cases.
Purpose of the Study:
- To evaluate the efficacy of custom-designed surgical resection for lung damage in children with bronchiectasis.
- To assess the outcomes of surgical treatment for pediatric bronchiectasis secondary to ghee aspiration.
Main Methods:
- Retrospective case series involving six children (7-12 years old) with lipoid bronchiectasis post-ghee aspiration.
- Children included had failed medical management and underwent surgical resection of severely affected lung segments.
- Data collected on surgical outcomes and post-operative symptom resolution.
Main Results:
- No surgical mortality was observed.
- Significant improvement in pre-operative symptoms, including resolution of cough, was noted in most patients.
- Two patients died more than six months post-operatively due to the advanced nature of the underlying disease.
Conclusions:
- Custom-designed surgical resection is a viable option for diffuse bronchiectasis unresponsive to medical therapy.
- Lung resection can effectively manage severe bronchiectasis resulting from early-life ghee aspiration.
- Careful patient selection is crucial, considering the potential for late mortality in advanced disease.
Objective:
To see the effect of "custom-designed" surgical resection of some severely damaged parts of the lungs in children with bronchiectasis caused by forced feeding of children early in their lives with animal fat "ghee".
Design:
All children with bronchiectasis--post lipoid pneumonia--who failed to respond to medical treatment had surgical removal of most affected parts of their lungs.
Settings:
Asir Central Hospital Abha, a referral hospital in Asir region of Saudi Arabia and a Teaching Hospital for College of Medicine and Health Sciences, King Khalid University, Saudi Arabia.
Subjects:
Six children aged between seven and 12 years with lipoid bronchiectasis were referred to paediatric surgical service for surgical treatment.
Results:
There was no surgical mortality. Apart from mild cough, all the pre-operative symptoms of the children disappeared. Two children died more than six months post-operatively due to the extent of the original disease.
Conclusion:
Surgical resection designed to remove the most affected parts of the lungs in diffuse-type bronchiectasis is recommended when there is failure of medical treatment.