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Allergy and Airway |

Unusual Cause of Cough: Bronchial Atresia

Penchala Mittadodla, MD; Mohan Rudrappa, MD; Mohammad Siddiqui, MD
Chest. 2013;144(4_MeetingAbstracts):9A. doi:10.1378/chest.1704904
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Abstract

SESSION TITLE: Airway Case Report Posters

SESSION TYPE: Affiliate Case Report Poster

PRESENTED ON: Tuesday, October 29, 2013 at 01:30 PM - 02:30 PM

INTRODUCTION: Congenital bronchial atresia is a rare entity, mostly discovered as an incidental finding on chest imaging. It usually involves the atresia of a segmental or subsegmental bronchus. It is one of the differential diagnoses of finger-in-glove sign where mucus is impaction occurs in the lung and surrounded by hyperlucent lung

CASE PRESENTATION: A 50-year-old female presented with chronic cough and an abnormal chest radiograph. She usually had worsening of her cough during spring and summer months, and had used over the counter cough suppressants. She denied any shortness of breath, wheezing, hemoptysis, or chest pain. She had 30 pack year smoking history. she was not in any respiratory distress with Respiratory rate of 12/min and resting saturation of 99%. The breath sounds were decreased in the right upper thorax with normal vesicular breaths sounds without any adventitious sounds elsewhere. A chest radiograph showed an ill-defined, elongated mass in the right middle lung zone. CT scan showed irregular tubular structure with mucus impaction, presenting like finger in glove appearance in the right upper lobe (Fig 1). The apical segment of the right upper lobe could not be traced. Bronchoscopy (Fig 2) showed only two segmental division of the right upper lobe and also a remnant of superior segment of the lower lobe

DISCUSSION: Bronchial atresia is hypothesized to develop as a result of intrauterine ischemia after the 16th gestational week. The chest x ray shows tubular or nodular area of increased opacity that extends from the hila. CT scan more sensitive and shows triad of focal interruption of a bronchus, bronchocele, and associated hyperinflation of the obstructed pulmonary segment

CONCLUSIONS: Bronchial atreisa is one of the causes of focal hyperlucnet lung along with finger glove appearence on radiograms. Most pateints with bronchial atresia are asymptamatic and require no treatment. CT scan and bronchoscopy helps to rule out other causes like cystic fibrosis, ABPA and bronchiectasis .

Reference #1: Congenital bronchial atresia (CBA). A critical review of CBA as a disease entity and presentation of a case series. Pedicellj G and et all. Radiol Medi: 110(5-6):544-53

Reference #2: Congenital bronchial atresia: diagnosis and treatment. Wang Y and et all . Int j Med Sci: 207-12:2012;9(3).

DISCLOSURE: The following authors have nothing to disclose: Penchala Mittadodla, Mohan Rudrappa, Mohammad Siddiqui

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