Sequential bronchoscopy in the management of lobar atelectasis secondary to allergic bronchopulmonary aspergillosis

Lobar atelectasis is a common complication in patients with cystic fibrosis. Failure to reexpand the lung isassociated with poorer outcomes. We report sequential weekly flexible bronchoscopy, with instillation of recombinant human DNase, in 5 patients with cystic fibrosis who had lobar collapse secondary to allergic bronchopulmonary aspergillosis. The number of procedures ranged from 2 procedures in 3 patients, 3procedures in 1 patient, and 4 procedures in another patient. All the patients achieved full reexpansion radiologically and the procedures were well tolerated. We conclude that sequential bronchoscopy in patients who fail to show reexpansion of the lung is effective and should be considered as part of standard medical management.