[A case of tracheobronchomegaly]

We report a rare case of tracheobronchomegaly with crescent-type tracheobronchomalacia. A 77-year-old man with a chronic cough was referred to our hospital because of fever and dyspnea. Radiographic examination showed enlargement of the trachea and main bronchi. On chest radiography, the transverse diameter of the trachea was 31 mm, and consolidation shadows were seen in both upper lung fields. Tracheobronchomegaly with pneumonia was diagnosed. The pneumonia was improved by administration of PAPM/BP. On bronchoscopic examination, the trachea and main bronchi were extremely dilated on inspiration, and were collapsed on expiration. The biopsy specimen from the bronchial mucosa showed non-specific chronic inflammation.

Prenatal diagnosis of tracheal obstruction: possible association with maternal pertussis infection

A fetus with the sonographic appearance of echogenic and enlarged lungs and dilated trachea and bronchi, indicating laryngotracheal obstruction, is reported. Additionally, the fetus had ascites and subcutaneous edema and the amniotic fluid volume was reduced. Doppler flow investigation of the systemic venous circulation revealed signs of heart failure, and color Doppler visualized possible increased pulmonary flow. Following termination of pregnancy, autopsy confirmed the sonographic observations and revealed a hypoplastic thymus. During the present pregnancy the mother suffered from sustained cough, and serological tests revealed acute pertussis infection. Polymerase chain reaction investigation for Bordetella pertussis in the amniotic fluid was negative. The possibilities of pertussis toxins as noxious factors and of an atypical presentation of DiGeorge anomaly are discussed.

[Treatment of tracheobronchomegaly using the Freitag prosthesis]

Tracheobronchomegaly (TBM) is a rare disorder. It is characterised by a dilatation of the trachea and subsequent bronchial divisions associated with a dynamic pathology, in particular a cough which explains the symptomatology of the patients. We report the observation of a patient suffering from TBM whose clinical progress rapidly improved after the insertion of a Freitag prosthesis. This 60-year-old male presented with a year's history of chronic cough which was painful, cavernous and had been incapacitating associated with moderate dyspnoea of effort. Bronchial endoscopy showed dyskinesia extending almost totally throughout the tracheobronchial tree with complete expiratory collapse. The FEV1, the Vital Capacity and the TLC were subnormal and the PEF was 57% of the predicted. The total airways resistance (RAW) was elevated (306% of the predicted), the arterial blood gases were normal. A CT scan showed a deformed trachea with increased diameter. A tracheobronchial prosthesis of Freitag or Dynamic stent (Rüsch) was inserted with the help of a rigid bronchoscope. One month later the cough had regressed and the effort dyspnoea had disappeared. One year later the clinical improvement persisted with very good tolerance of the prosthesis with normal spirometry despite the persistence of an elevated RAW. Despite a recoil which is still imperfect the tracheobronchial endoprosthesis seems to be a useful treatment for forms of TBM which are potentially progressive.

Tracheomegaly in Brachmann-de Lange syndrome

Brachmann-de Lange syndrome is a well-described congenital disorder. Skeletal anomalies and respiratory infections are its hallmarks. To the known imaging signs, the authors add tracheomegaly, which has not been reported so far.

[Tracheobronchomegaly (Mounier-Kuhn syndrome): roentgen findings and tracheal stent instrumentation]

Tracheobronchomegaly is a rare disorder of the lower respiratory tract characterised by marked dilatation of the trachea and the central bronchi associated with recurrent respiratory tract infections. However, some patients with tracheobronchomegaly are not detected because the symptoms are overlooked if chest radiographs alone are used for diagnosis. We encountered two cases of tracheobronchomegaly that were not diagnosed by chest radiographic examinations but were shown clearly with CT. We believe that patients with recurrent pulmonary infection must be examined with the use of CT.

Anaesthesia for a patient with tracheobronchomegaly (Mounier-Kuhn syndrome)

Tracheobronchomegaly is a rare condition in which anaesthetic experience is limited. Patients with tracheobronchomegaly are at risk of large airway collapse and obstruction, aspiration pneumonitis and tracheal trauma following airway instrumentation. We describe our anaesthetic technique and problems encountered during nephrectomy in a patient with this condition.

Dynamic computed tomography evaluation of tracheobronchomegaly

The authors report a case of tracheobronchomegaly in a 62-year-old man with chronic expiratory cough. Computed tomography showed dilatation of the trachea on inspiration and complete collapse of the trachea and the proximal bronchi on full expiration. The authors discuss the importance of the collapse on expiration as the cause of the patient's symptoms.

Mounier-Kuhn syndrome (tracheobronchomegaly)

This paper describes a case of tracheobronchomegaly, which is a rare condition. The radiological, bronchoscopic and computed tomographic (CT) appearance of the condition are described. Together with the patient's history, these examinations are very useful in diagnosis, since, in cases of patients with chronic recurrent respiratory infections, they help us review any anatomical abnormalities.

Tracheobronchomegaly in preterm infants on mechanical ventilation

Tracheobronchomegaly (TBM) was diagnosed on chest radiographs as an apparent dilatation of the trachea and main bronchi in four premature infants on prolonged mechanical ventilation for respiratory distress syndrome. In a retrospective study, the parameters of assisted ventilation, the Apgar score, the presence of conatal or later infection, and hypotension were reviewed and analyzed as factors possibly contributing to the pathogenesis of TBM in these infants. The results lead to the conclusion that TBM in premature infants on prolonged ventilatory support is an acquired condition though a congenital defect cannot be excluded as a probable predisposing factor. In the etiopathogenesis of TBM, a repeated barotrauma of prolonged ventilation is a crucial factor while the severity of lung disease and the degree of prematurity, hypotension, infection, and generally poor clinical condition, all appear to be relevant in the development of TBM in a premature infant with respiratory distress syndrome.

[Tracheobronchomegaly associated with light chain deposition disease]

Tracheobronchomegaly, also known as Mounier-Kühn's Syndrome, is characterized by market dilation of the trachea and main bronchi and has been reported in association with several conditions, particularly connective tissue disease. The pathogenesis and clinical signs of light chain deposition disease are similar to those of light chain amyloidosis, in which these chains are deposited as amorphous material lacking the tinctorial features of the amyloid. We present a case involving both entities, an association that has not been previously reported, and we review the main characteristics of both diseases.

The association of tracheomegaly and bronchiectasis

This study set out to determine the frequency of tracheomegaly in brochiectasis as judged by high resolution computed tomography (HRCT) while determining whether the published normal tracheal dimensions derived from radiographic data can be used for CT diagnosis. Seventy-five consecutive adults referred for CT assessment of possible bronchiectasis were studied and compared with a control group of 75 adults being staged for lymphoma. The internal tracheal diameters at aortic arch level of the control group correspond with published radiographic data and using these measurements, 7/42 (17%) patients with bronchiectasis were found to have tracheomegaly, while two of the 33 'symptomatic' patients (i.e. those patients not found to have bronchiectasis) had tracheomegaly. Further analysis confirmed that the bronchiectatic group's tracheal dimensions were significantly different from those of the control group while the 'symptomatic' group are an overlap population. We conclude that tracheomegaly is a frequent finding in bronchiectasis.

Tracheobronchomegaly: an unusual presentation of a rare condition

Tracheobronchomegaly is a rare cause of recurrent chest infections often with persistent, unproductive cough. A case is described which presented as a severe life threatening pneumonia in which the bronchoscopic, radiographic, and computed tomographic findings are given.

[A rare case of tracheobronchomegaly]

The reported case confirms that tracheobronchomegaly may have a symptomless course. Exacerbation of process may be interpreted as "pneumonia". Only in the long course of the disease without positive clinico-roentgenological dynamics the correct diagnosis is established.

Tracheobronchiomegaly. The Mounier-Kuhn syndrome in a patient with the Kenny-Caffey syndrome

A 36-year-old woman with features of both the Mounier-Kuhn syndrome and the Kenny-Caffey syndrome is described. To our knowledge, this is the first reported case of these syndromes occurring together. Three-dimensional computed tomographic reconstruction of the upper airway revealed marked dilatation of the trachea and main-stem bronchi and several large diverticulae of the trachea.