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Bronchial obstruction secondary to idiopathic scoliosis in a child: a case report

Saad Alotaibi1, James Harder, Sheldon Spier

  • 1Alberta Children's Hospital, University of Calgary, AB, Canada. saalotai@hotmail.com

Journal of Medical Case Reports
|May 24, 2008
PubMed

Insights

Severe scoliosis can cause serious lung problems. This case highlights how airway twisting in children with scoliosis can lead to airflow obstruction, detectable by spirometry and bronchoscopy.

Area of Science:

  • Pulmonology
  • Pediatric Respiratory Medicine
  • Medical Case Reports

Background:

  • Severe idiopathic scoliosis is associated with significant pulmonary complications.
  • These complications include recurrent chest infections, alveolar hypoventilation, and respiratory failure.
  • Airway obstruction is a potential, though less commonly reported, complication.

Purpose of the Study:

  • To report a case of a pediatric patient with moderate-to-severe scoliosis.
  • To investigate the cause of airflow obstruction in this patient.
  • To highlight the utility of pulmonary function testing and bronchoscopy in diagnosing intrathoracic airway obstruction in scoliosis.

Main Methods:

  • Case presentation of a 13-year-old boy with moderate-to-severe scoliosis.
  • Spirometry to assess pulmonary function and identify airflow obstruction defects.
  • Flexible bronchoscopy for direct visualization of intrathoracic airways.

Main Results:

  • Scoliosis in the patient resulted in torsion (twisting) of the bronchus intermedius.
  • This bronchial twisting contributed to significant airflow obstruction defects.
  • Spirometry revealed obstructive lung disease patterns, confirmed by bronchoscopy.

Conclusions:

  • Inspection of the maximal expiratory flow-volume loop from spirometry is recommended for children with scoliosis.
  • Parameters suggestive of obstructive lung disease should be evaluated in pediatric scoliosis patients.
  • This is the first report detailing the combined use of pulmonary function testing and flexible bronchoscopy to characterize intrathoracic large airway obstruction in a child with scoliosis.
Abstract

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