• Title/Summary/Keyword: Bronchoscopy

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Virtual computed tomographic bronchoscopy: normal bronchial anatomy in six dogs

  • Oh, Dayoung;Choi, Mincheol;Yoon, Junghee
    • Korean Journal of Veterinary Research
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    • v.57 no.2
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    • pp.113-116
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    • 2017
  • The aim of this study was to examine normal bronchi in dogs by using virtual bronchoscopy (VB) and to evaluate the utility of VB in clinical practice. The bronchi of six dogs without tracheobronchial disease were visualized by VB. Airways from the tracheal bifurcation to the lobar bronchi were well visualized in all dogs. Segmental and subsegmental bronchi were also well identified, but the degree and number of those varied with dog size. The mean numbers of segmental and subsegmental bronchi identified in the six dogs were 41.83 and 50.17, respectively, whereas, the mean numbers in medium- and large-sized dogs were 55.00 and 82.67, respectively, and in small-sized dogs, the means were 28.67 and 17.67, respectively. Although there were size-dependent differences in VB visualization of the bronchi, it was possible to identify peripheral airways to the subsegmental bronchi level, which can rarely be accomplished via conventional bronchoscopy. VB is the noninvasive method that can be used to examine bronchial anatomy, and our results suggest that VB can be useful for evaluating bronchi, including segmental and subsegmental ones that cannot be examined routinely by conventional bronchoscopy. Thus, VB has potential as an alternative to conventional bronchoscopy in the examination of bronchi in dogs.

The Two Cases of Initial Foreign Body Removal Failure Using Bronchoscopy (기관지 내시경으로 초기에 제거할 수 없었던 기도 이물 : 2례 보고)

  • Kim, Yeon-Soo;Nam, Seung-Yeon;Kwak, Byeong-Gon;Chang, Woo-Ik;Park, Kyung-Taek;Kim, Chang-Young;Ryoo, Ji-Yoon
    • Korean Journal of Bronchoesophagology
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    • v.13 no.2
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    • pp.77-81
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    • 2007
  • Foreign body aspiration is a cause of the accidental death at home. Therefore, early intervention and proper management is important. A bronchoscopy is indicated whenever there is a suggestive history and medical opinion. Occasionally, foreign body removal with bronchoscopy may be fail. But, on the situation, there is no definite recommended standard management. We experienced two cases of bronchial foreign body could not be removed with bronchoscopy at first intervention. The one was diagnosed too late. Endobronchial granulation tissue and edema made it impossible to find the foreign body at first bronchoscopy. After steroid and antibiotic therapy, foreign body could be removed with secondary bronchoscopy. Another was bronchial foreign body jammed tightly bronchus intermedius. Even after medical therapy, patient got aggravated. So foreign body was removed with bronchotomy.

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A Case of Removal of Pushpin by Flexible Bronchoscopy (굴곡성 기관지경을 이용한 기관지내 압정 제거 1예)

  • Hong, Seong-Bin;Song, Joon-Ho;Kwak, Seung-Min;Cho, Chul-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.772-776
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    • 1995
  • Aspiration of foreign body, a clinical problem seen more commonly in the pediatric age group, is infrequently seen in the adult population. Although rigid bronchoscopy has been the mainstay of treatment, recently, easier manipulation, greater range of visulization, flexibility, topical anesthesia has made flexible bronchoscopy of choice for dealing with aspirated foreign body in adult. Operation increase morbidity and mortality, delay foreigh body removal. A 41-year old male was admitted to this hospital due to aspiration of pushpin. He showed high opaque density protruding in the orifice of right lower lobar bronchus. We report a case of foreign body removal by flexible bronchoscopy with brief review of the literature.

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Rigid Bronchoscopy for Post-tuberculosis Tracheobronchial Stenosis

  • Hojoong Kim
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.4
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    • pp.245-250
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    • 2023
  • The healing process of tracheobronchial tuberculosis (TB) results in tracheobronchial fibrosis causing airway stenosis in 11% to 42% of patients. In Korea, where pulmonary TB is still prevalent, post-TB tracheobronchial stenosis (PTTS) is one of the main causes of benign airway stenosis causing progressive dyspnea, hypoxemia, and often life-threatening respiratory insufficiency. The development of rigid bronchoscopy replaced surgical management 30 years ago, and nowadays PTTS is mainly managed by bronchoscopic intervention in Korea. Similar to pulmonary TB, tracheobronchial TB is treated with combination of anti-TB medications. The indication of rigid bronchoscopy is more than American Thoracic Society (ATS) grade 3 dyspnea in PTTS patients. First, the narrowed airway is dilated by multiple techniques including ballooning, laser resection, and bougienation under general anesthesia. Then, most of the patients need silicone stenting to maintain the patency of dilated airway; 1.5 to 2 years after indwelling, the stent could be removed, this has shown a 70% success rate. Acute complications without mortality develop in less than 10% of patients. Subgroup analysis showed successful removal of the stent was significantly associated with male sex, young age, good baseline lung function and absence of complete one lobe collapse. In conclusion, rigid bronchoscopy could be applied to PTTS patients with acceptable efficacy and tolerable safety.

Prediction of Intubation after Bronchoscopy with Non-invasive Positive Pressure Ventilation Support in Patients with Acute Hypoxemic Respiratory Failure (급성 저산소혈증 환자에서 비침습적 양압환기 적용 하 기관지경 검사 후 기관 삽관의 예측 인자)

  • Song, Jae-Uk;Kim, Su-A;Choi, E Ryoung;Kim, Soo Min;Choi, Hee Jung;Lim, So Yeon;Park, So Young;Suh, Gee Young;Jeon, Kyeongman
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.1
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    • pp.21-26
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    • 2009
  • Background: Non-invasive positive pressure ventilation (NPPV) ensures adequate gas exchange during bronchoscopy in spontaneously breathing, hypoxemic patients, thus avoiding endotracheal intubation. However, in some patients, endotracheal intubation is eventually required after bronchoscopy. This study investigated the incidence of intubation and predictors of a need for emergency intubation prior to NPPV bronchoscopy initiation. Methods: On a retrospective basis, we reviewed the medical records of 36 patients (median age, 55 years; interquartile range [IQR], 43~65 years) with acute hypoxemic respiratory failure who required NPPV during bronchoscopy between January 2005 and October 2007. Results: All patients were hypoxemic (median $PaO_2/FiO_2$ ratio 155; IQR 90~190), but tolerated bronchoscopy with NPPV support. SOFA score and SAPS II score immediately before NPPV initiation were 4 (3~7) and 36 (30~42), respectively. Seventeen (47%) patients needed endotracheal intubation at a median time of 22 (2~50) hours after bronchoscopy. Patients who needed intubation after bronchoscopy had a higher in-hospital mortality (11 [65%] vs. 4 [21%], p=0.017). Upon multiple logistic regression analysis, the need for intubation after bronchoscopy was independently associated with a $P_aO_2/FiO_2$ ratio (OR, 0.961; 95% CI, 0.924~0.999; p=0.047) immediately before NPPV initiation for bronchoscopy. Conclusion: The severity of the hypoxemia immediately prior to NPPV initiation for bronchoscopy was associated with the need for intubation after bronchoscopy in patients with hypoxemic respiratory failure.

Optimal Time to Localize Bleeding Focus and the Usefulness of Flexible Bronchoscopy in Hemoptysis (객혈에서 굴곡성 기관지경의 출혈부위 결정을 위한 적절한 시행시기 및 그 유용성)

  • Lee, Jae-Ho;Koh, Won-Joong;Lee, Chan-Ju;Chung, Hee-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.3
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    • pp.353-364
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    • 2000
  • Background : Bronchoscopy is a useful diagnostic tool, for accurate localization of the bleeding site and the management of hemoptysis. However, there is some controversy about the optimal timing of bronchoscopy. Method : To determine the optimal timing of bronchoscopy in hemoptysis, we reviewed the medical records of 118 patients and analyzed the following relationships amongst simple chest PA findings, namely, the duration and amount of hemoptysis, and the timing of bronchoscopy retrospectively. Results : The major causes of hemoptysis were active tuberculosis(28.8%), inactive tuberculosis(10.2%), bronchiectasis(17.0%), lung cancer(7.6%), and aspergilloma(7.6%). Localization of the bleeding focus by bronchoscopy was possible in 87.5% (21/24 cases) during active bleeding, and it was possible in 40.4% after bleeding had stopped(p<0.05). The localization rate of bleeding focus was 59.8% when the chest PA showed certain abnormalities, but it decreased to 27.8% when the chest PA finding was normal(p<0.05). When chest PA showed diffuse abnormalities or its finding was normal, the localization rate of bleeding focus significantly increased if bronchoscopy was performed during bleeding or within 48 hours of the cessation of active bleeding. The localization rate was higher as the amount of hemoptysis became larger(p<0.05). The localization rate of early bronchoscopy(during bleeding or within 48 hours of the cessation of active bleeding) was significantly higher when the duration of hemoptysis was less than 1 week, but there was no advantage if the duration was 1 week or longer. Early bronchoscopy was also necessary to localize the bleeding focus for surgical resection in 4 patients, and the bronchoscopy itself was therapeutic in 1 patient whose bleeding was successfully managed with thrombin-application via bronchoscope. Conclusion : It is concluded that flexible bronchoscopy is useful at not only localizing the bleeding focus but also in preparing a therapeutic plan, and early bronchoscopy is more favorable in hemoptysis.

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A CASE OF BRONCHIAL FOREIGN BODY REMOVED BY TRACHEOSTOMY AND NASAL ENDOSCOPY (기관절개 및 비내시경을 이용하여 치험한 기관이물 1례)

  • 임상철;조재식
    • Korean Journal of Bronchoesophagology
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    • v.2 no.2
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    • pp.244-247
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    • 1996
  • Most of bronchial foreign bodies can be removed by ventilation bronchoscopy through transoral route but sometimes, ventilation bronchoscopy through tracheostomy is helpful procedure. Recently, we have experienced a case of bronchial foreign body which could be easily removed by nasal endoscopy and Blakesley forcep instead of bronchoscopy. So we report this case with a review of literatures.

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A Case of Broncholithiasis (기관지결석증 치험 1례)

  • 배홍갑;이웅렬;조태환;성창섭
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.9.1-9
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    • 1983
  • By the technological improvement of bronchoscopy, radiology, and biochemical analysis, the broncholithiasis can be easily diagnosed. But because of its low incidence it has been frequently overlooked in the differential diagnosis of bronchial obstruction, thereby losing the opportunity of early detection and causing complications which are mandatory to surgical intervention. The authors had a case of broncholithiasis which was diagnosed by radiological study of chest and fiberoptic bronchoscopy, and was removed under rigid bronchoscopy.

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Difficult Airway Management with Fiberoptic Bronchoscopy Combined with Video Laryngoscope in a Patient with Ludwig Angina (Ludwig's Angina 환자의 어려운 기도 관리에서 기관지내시경과 비디오 후두경의 병용 경험)

  • Song, Jaegyok;Kim, Seokkon;Bae, Jeong-Ho
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.4
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    • pp.189-193
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    • 2013
  • We experienced dfficult airway management in a patient who had Ludwig angina with morbid obesity, dfficulty with mouth opening and neck extension. We planned to perform awake-nasotracheal intubation with fiberoptic bronchoscopy but the patient's condition was not suitable to do this procedure. Thus, we tried fiberoptic nasotracheal intubation under general anesthesia but we experienced difficult airway management due to epistaxis. We tried to use video laryngoscope instead of fiberpotic bronchoscopy but also failed to guide the tube into trachea due to limited mouth opening. We used video laryngoscope to make a view of vocal cord and used fiberoptic bronchoscope as an intubation guide of endotrachedal tube and successfully intubated the patient.

A Case of Tracheal Carcinoma Diagnosed by Rigid Bronchoscopy in Lidocaine Anaphylaxis Patient (리도카인 아나필락시스 환자에서 경직 기관지내시경술을 통해 기도 암종을 진단한 1예)

  • Yoon, Byeong Kab;Ban, Hee Jung;Kwon, Yong Soo;Oh, In Jae;Kim, Kyu Sik;Kim, Yu Il;Lim, Sung Chul;Kim, Young Chul;Song, Sang Yoon
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.2
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    • pp.140-144
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    • 2009
  • The majority of flexible bronchoscopies are performed under topical anesthesia with lidocaine being the most commonly used agent. Anaphylaxis rarely occurs after local administration of lidocaine, but can be a fatal complication. We experienced a case of unexpected anaphylaxis. A 66-year-old woman was scheduled for flexible bronchoscopy to evaluate a tracheal mass and stenosis. The oral and nasal mucosa were pretreated with lidocaine. About 2~3 minutes later, the patient developed hypotension and we treated for anaphylaxis in the emergency room. Then, we decided to perform rigid bronchoscopy in this patient, under conditions of general anesthesia. A rigid bronchoscopy was performed in this patient, safely and successfully. The tracheal mass was determined to be squamous cell carcinoma.