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Sao Paulo Medical Journal
versão impressa ISSN 1516-3180
MELLO, Ramon Andrade de; MAGALHAES, Adriana e VILAS-BOAS, Abílio José. Stridor and respiratory failure due to tracheobronchomalacia: case report and review of the literature . Sao Paulo Med. J. [online]. 2012, vol.130, n.1, pp. 61-64. ISSN 1516-3180. http://dx.doi.org/10.1590/S1516-31802012000100011.
CONTEXT: Tracheobronchomalacia (TBM) results from structural and functional abnormalities of the respiratory system. It is characterized by excessive collapse: at least 50% of the cross-sectional area of the trachea and main bronchi. In this paper, we present a rare case of a patient with TBM who first presented with stridor and respiratory failure due to exacerbation of chronic bronchitis. CASE REPORT: An 81-year-old Caucasian man was admitted presenting coughing, purulent sputum, stridor and respiratory failure. He had a medical history of chronic obstructive pulmonary disease (COPD) and silicosis and was a former smoker. Axial computed tomography on the chest revealed marked collapse of the trachea in its middle third. Bronchoscopy showed characteristics compatible with TBM. He was treated with noninvasive ventilation, without any good response. Subsequently, a Dumon Y stent was placed by means of rigid bronchoscopy. After the procedure, he was discharged with a clinical improvement. CONCLUSION: TBM is fatal and often underdiagnosed. In COPD patients, stridor and respiratory failure may be helpful signs that should alert physicians to consider TBM as an early diagnosis. Thus, these signs may be important for optimizing the treatment and evolution of such patients.
Palavras-chave : Tracheobronchomalacia; Respiratory sounds; Pulmonary disease, chronic obstructive; Dyspnea; Respiratory insufficiency.