Açık kalp ameliyatı sonrası beklenmedik bir atelektazi olgusu: Trakeobronkopati osteokondroplastika

Trakeobronkopati osteokondroplastika (TO) trakea ve bronşların lümeni içine yayılan submukozal kemik ve kıkırdak içeren nodüllerle karakterize ve çeşitli derecelerde trakeal daralmayla seyreden nadir bir bozukluktur. Selim, yavaş ilerleyen ve prognozu iyi bir hastalık olmasına rağmen nadir de olsa ciddi trakeal stenoz meydana getirebilir. Olgumuzda da olduğu gibi operasyon sonrasında normal hastalarda atelektazi yaratmayacak küçük mukus tıkaçları TO’da zaten varolan trakeobronşial darlıklar yüzünden kolaylıkla atelektazi oluşturarak mortalite ve morbidite riskini artırabilmektedir. Burada açık kalp ameliyatı sonrası atelektazi ile seyreden TO olgusu sunulmuştur.

Anahtar Kelimeler:

Pulmoner atelektazi, Erkek, Ameliyat sonrası komplikasyonlar, Bronkoskopi, Yaşlı

An unexpected cause of atelectasis after open heart surgery: Tracheobronchopathia osteochondroplastica

Tracheobronchopathia osteochondroplastica (TO) is an uncommon abnormality of the cartilaginous tracheal wall, characterized by the presence of osteocartilaginous calcified nodules within the submucosa, with variable degree of diffuse tracheal narrowing. Although TO is a creeping disease with a good prognosis, it may rarely raise a serious tracheal stenosis.Here we report a case of TO, discovered incidentally after open heart surgery; the coincidence of these processes has never been reported before.

Keywords:

Pulmonary Atelectasis, Male, Postoperative Complications, Bronchoscopy, Aged,

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1. Leske V, Lazor R, Coetmeur D, Crestani B, Chatte G, Cordier CF. Tracheobronchopathia Osteochondroplastica: A study of 41 patients. Medicine (Baltimore) 2001:80:378-90.
2. Vilkman S, Keistinen T. Tracheobronchopathia Osteochondroplastica. Repot of a young man with severe disease and retrospective review of 18 cases. Respiration 1995;62: 151-4.
3. Karlıkaya C, Yuksel M, Kiliçli S, Candan L. Tracheobronchopathia Osteochondroplastica. Respirology 2000;5: 377-80.
4. Ferguson J, McCaffrey TV, Kern EB, Martin WJ. Effect of Klebsiella ozaenae on ciliary activity in vitro: implications in the pathogenesis of atrophic rhinitis. Otolaryngol Head Neck Surg 1990;102: 207-11.
5. Park SS, Shin DH, Lee DH, Jeon SC, Lee JH, Lee JD. Tracheopathia osteoplastica simulating asthmatic symptoms. Diagnosis by bronchoscopy and CT. Respiration 1995;62: 43-5.
6. Tajima K, Yamakawa M, Katagiri T, Sasaki H. Immunohistochemical detection of bone morphogenetic protein-2 and transforming growth factor beta-1 in tracheopathia osteochondroplastica. Virchows Arch 1997;431:359-63.
7. Dail DH. Metabolic and other diseases. In: Dail DH, Hammar SP, editors. Pulmonary pathology 2nd end. New York: Spiringer–Verlag; 1994.p. 707-77.
8. Restrepo S, Pandit M, Villamil MA, Rojas IC, Perez JM, Gascue A. Tracheobronchopathia Osteochondroplastica: helical CT findings in 4 cases. J Thorac Imaging 2004;19: 112-6.
9. Zack JR, Rozenshtein A. Tracheobronchopathia Osteochondroplastica: report of three cases. J Comput Assist Tomogr 2002;26: 33-6.