Airway Stenosis

of Right Middle Lobe Airway Branch

Patient History

A young woman presenting with recurrent right middle lobe pneumonia. Chest x-ray showed a right middle lobe syndrome. Bronchoscopy showed a significant (90%) stenosis of the right middle lobe. Using CT reconstructions, balloon bronchoplasty was undertaken, with forceps removal of the boncholith through the now open right middle lobe segment. All procedures were performed under local anesthesia.



Displayed above and to the left is a bronchoscopic image of the right middle lobe viewed from the origin of the middle lobe distally. The middle lobe has a clear stenosis which appears fibrotic, and adjacent (see arrow) to the very small lumen is a creamy colored object which is in fact a broncholith.

MPEG Movies

Original Electron Beam CT data

The original trans axial section EBCT data set. The images are 3 mm thick.

3D Reconstruction of Airways

3D reconstruction of airway tree showing obstruction of the main airway branch supplying the middle lobe of the right lung

Bronchoscopy

Shown is three clips merge together of the original bronchoscopic procedure. The first clip starts at the bifurcation of the bronchus. The second and third clips are of the right branch of the bronchus.


Summary

The CT reconstruction demonstrated that while the extent of the stenosis was severe, the length was very small, making an ideal case for balloon bronchosplasty.




©1994-99 Division of Physiologic Imaging, Dept. of Radiology, Univ. of Iowa


Bronchoscopy | Tutorials | DPI Homepage | VIDA | NLM | Contact Us | Search

Last modified: Fri Jun 4 11:36:31 CDT