Cough caused by exposed endobronchial sutures

Area of Science:

• Pulmonology
• Thoracic Surgery
• Gastroenterology

Background:

• Patients undergoing resectional lung surgery may experience persistent or recurrent cough post-operatively.
• Differential diagnosis for post-thoracotomy cough typically includes disease recurrence, infection, or inflammation.

Observation:

• Five patients with histories of lung resectional surgery presented with persistent cough.
• Initial diagnosis considered disease recurrence, but bronchoscopy revealed exposed endobronchial sutures.

Findings:

• Exposed endobronchial sutures were identified as the cause of cough in all five patients.
• Suture elimination, either spontaneous or via bronchoscopic removal, resolved the cough in all cases.
• Mechanism involves local irritation, granuloma formation, and infection secondary to exposed sutures.

Implications:

• Exposed endobronchial sutures are a critical, often overlooked, cause of post-thoracotomy cough.
• Consideration of this etiology can prevent misdiagnosis and unnecessary treatments for recurrent disease.
• Bronchoscopic evaluation is key for diagnosing and managing suture-related cough.