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Robotic-assisted Left Pneumonectomy For Vanishing Lung Syndrome

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Tracheobronchomalacia post-pneumonectomy: a late complication.

Ashima Datey¹, Avinash Chaskar, Latha Sarma

¹Department of Pulmonology, Krishna Institute of Medical Sciences, Secunderabad, Andhra Pradesh, India.

Indian Journal of Palliative Care

|September 20, 2013

Summary

A rare case of tracheobronchomalacia developed 40 years after pneumonectomy, causing airway obstruction. Conservative tracheostomy management proved effective for this elderly patient.

Keywords:

Post pneumonectomy syndrome Post-pneumonectomy Stridor Tacheobronchomalacia

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Area of Science:

Pulmonology
Thoracic Surgery
Medical Imaging

Background:

Post-pneumonectomy syndrome can lead to mediastinal shift.
Tracheobronchomalacia is a rare complication, especially decades after surgery.
Airway collapse can cause significant respiratory distress.

Observation:

An 83-year-old male with a history of pneumonectomy presented with dyspnea and stridor.
Dynamic CT and fiber optic bronchoscopy revealed tracheobronchomalacia with expiratory airway closure.
The patient had a severe mediastinal shift due to post-pneumonectomy syndrome.

Findings:

Tracheobronchomalacia occurred 40 years post-pneumonectomy, a highly unusual timeline.
Near-total expiratory collapse of the trachea and bronchi was confirmed.
Conservative management with a long tracheostomy was successful in improving symptoms.

Implications:

This case highlights the potential for delayed tracheobronchomalacia in post-pneumonectomy patients.
Early diagnosis using dynamic CT and bronchoscopy is crucial.
Non-invasive or conservative management may be viable for select patients, avoiding more invasive procedures.