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Aspiration and altered airway anatomy: a presentation with a twist

Aspiration and altered airway anatomy: a presentation with a twist

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Tidsskriftspublikasjon
Sammendrag
A 60-year-old woman presented to our hospital with severe hypercapnic respiratory failure in the absence of a prior smoking history. She reported a 1-day history of increased dyspnoea and a cough productive of green sputum. Her medical history was significant for severe idiopathic scoliosis, cleft palate repair, rheumatoid arthritis, hypothyroidism and recurrent lower respiratory tract infections. She was obtunded on presentation and required 24 hours of mechanical ventilation. A CT thorax was performed to further investigate her acute deterioration. Considerable distortion of thoracic anatomy secondary to kyphoscoliosis was noted. Right lower lobe atelectasis due to extrinsic compression of the bronchus intermedius by thoracic vertebrae and left lower lobe consolidation were reported (figures 1–3). Due to the vertical orientation of the left main bronchus (LMB), aspiration pneumonia was suspected (figure 2). Our patient initially improved with antimicrobial therapy, dietary modifications and proton pump inhibitors and was discharged home.
Språk
Engelsk
Forfatter(e)
  • Cullivan Sarah
  • Langø Thomas
  • Cantillon-Murphy Pádraig
  • Kennedy Marcus P
Institusjon(er)
  • Irland
  • SINTEF Digital / Helse
  • Coláiste na hOllscoile Corcaigh
År
2018
Publisert i
BMJ Case Reports
ISSN
1757-790X
Forlag
B M J Group