Chest
Selected ReportsKyphoscoliosis and Bronchial Torsion
Section snippets
Case 1
A 40-year-old woman had gross congenital kyphoscoliosis and cor pulmonale leading to type 2 respiratory failure. The patient required assisted mechanical support in the form of nasal intermittent ventilation. Recurrent bouts of respiratory infection necessitated admission to the hospital on a nearly bimonthly basis. There was auscultatory and radiologic evidence of collapse of the lower and middle lobes of the right lung (Fig 1). Bronchoscopic appearance revealed complete obstruction of the
Comment
Severe kyphoscoliosis is associated with respiratory complications, often leading to respiratory failure. The progressive nature of the disease limits the vital capacity and chest wall compliance of the patients with the effect of normal changes with age. The reduced vital capacity and the severity of the scoliosis are the most important predicting factors in prognosis.1 Superinfection and muscle weakness also influence the respiratory function because of an increased work of breathing in those
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Cited by (32)
Successful Treatment of Bronchial Obstruction After Lobectomy in a Patient With Scoliosis
2020, Annals of Thoracic SurgeryCitation Excerpt :The probable pathogeneses of respiratory dysfunction in patients with scoliosis include a reduction in pulmonary volume, pulmonary extensibility, respiratory muscle strength, and compliance of the chest wall owing to deformity of the thorax. Airway distortion owing to deformity of the thoracic vertebra has been also reported as a pathogenesis.1-4 In the current case, the superior segmental bronchus appeared to be compressed by the dorsal thoracic vertebra on preoperative CT.
Disorders of the Chest Wall: Clinical Manifestations
2018, Clinics in Chest MedicineCitation Excerpt :As a result, the RV/TLC ratio is increased and sometimes misinterpreted as evidence of obstructive pathology. Obstructive physiology (expiratory flow limitation and increased airway resistance), however, may occur if the deformed spine causes bronchial torsion.13 Functional residual capacity is the lung volume at which the outward elastic recoil of the chest wall is balanced by the inward recoil of the lung.
Neurogenic respiratory failure
2013, Handbook of Clinical NeurologyCitation Excerpt :The normal aging process will also reduce lung volume (see Fig. 24.1). Torsion of the central airways can also occur and result in complete obstruction (Al-Kattan et al., 1997). NIPPV and not oxygen therapy alone is the primary therapy for respiratory insufficiency (Gustafson et al., 2006).
Respiratory muscle disorders in chest wall diseases
2003, Archivos de BronconeumologiaManaging ventilatory insufficiency and failure in a patient with kyphoscoliosis: a case study
2001, Australian Critical Care