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Have we got the full picture?

Published online by Cambridge University Press:  29 June 2007

R. Demajumdar  and
P. B. Rajesh
R. Demajumdar*
Affiliation:
Department of OtolaryngologyHeartlands Hospital, Birmingham, UK.
P. B. Rajesh
Affiliation:
Department of Cardiothoracic Surgery, Heartlands Hospital, Birmingham, UK.
*
Address for correspondence: R. Demajumdar, 9 The Green, Oldbury, Warley, West Midlands B68 8DU.
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Abstract

A 59-year-old man with long-standing chronic obstructive airways disease (COPD), became progressively dyspnoeic, and repeatedly blacked-out during forced expiration. Spirometry suggested the possibility of large airways obstruction, and failing to respond to aggressive bronchodilator and steroid therapy, the patient was labelled as being non-compliant. Finally, he was assessed by an otolaryngologist and a cause for upper airway obstruction was suspected. Bronchoscopy and computed tomography (CT) scanning demonstrated tracheomalacia and the patient underwent resection of this segment of abnormal trachea.

Tracheomalacia, although rare, results from the substitution of cartilage with fibrous tissue, leading to severe airway compromise.

This case emphasizes the fact that although many conditions are uncommon, the total incidence of rare conditions is surprisingly high, and that care needs to be taken at all times in the management of ‘labelled’ patients with chronic illness, in order not to overlook such life-threatening diagnoses.

Keywords

Lung diseases, obstructiveRespiratory soundsTracheomalacia
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 112 , Issue 8 , August 1998 , pp. 788 - 789
Copyright
Copyright © JLO (1984) Limited 1998

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References

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