Kaohsiung Journal of Medical Sciences
Volume 25, Issue 12 , Pages 680-684, December 2009

Focal Stenosis in Right Upper Lobe Bronchus in a Recurrently Wheezing Child Sequentially Studied by Multidetector-row Spiral Computed Tomography and Scintigraphy

  • I-Chen Chen

      Affiliations

    • Division of Pediatric Cardiology and Pulmonology, Department of Pediatrics, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Jiunn-Ren Wu

      Affiliations

    • Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Department of Pediatrics, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Chia-Ying Lu

      Affiliations

    • Department of Medical Imaging, Kaohsiung Medical University Hospital; Department of Pediatrics, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Chien-Ming Tseng

      Affiliations

    • Division of Pediatric Cardiology and Pulmonology, Department of Pediatrics, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Jong-Hau Hsu

      Affiliations

    • Division of Pediatric Cardiology and Pulmonology, Department of Pediatrics, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Zen-Kong Dai

      Affiliations

    • Division of Pediatric Cardiology and Pulmonology, Department of Pediatrics, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Department of Pediatrics Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Corresponding Author InformationAddress correspondence and reprint requests to: Dr Zen-Kong Dai, Department of Pediatrics, Kaohsiung Medical University Hospital, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan

Received 10 February 2009; accepted 27 March 2009.

Lower respiratory tract infections associated with wheezing are not uncommon in infants and young children. Among the wheezing-associated disorders, allergic etiologies are more commonly encountered than anatomic anomalies. We present a 3-year-old girl with a sudden attack of asthmatic symptoms including dyspnea, cyanosis and diffuse wheezing. Based on a history of choking, and atelectasis in the right upper lobe detected by chest films, flexible tracheobronchoscopy was arranged and incidentally detected a stenotic orifice in the right upper lobe bronchus. Multidetector-row spiral computed tomography and pulmonary scintigraphy subsequently also disclosed the focal stenosis. She suffered from recurrent wheezing, pneumonia and lung atelectasis during 1 year of follow-up. We emphasize the diagnosis, clinical course and management of focal stenosis in the right upper lobe bronchus.

Key Words:  flexible tracheobronchoscopy , multidetector-row spiral computed tomography , ventilation and perfusion scintigraphy

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PII: S1607-551X(09)70575-3

doi:10.1016/S1607-551X(09)70575-3

Kaohsiung Journal of Medical Sciences
Volume 25, Issue 12 , Pages 680-684, December 2009

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