Korean J Thorac Cardiovasc Surg.  1997 Oct;30(10):1040-1043.

A Case of Bronchiolitis Obliterans Organizing Pneumonia After Thoracotomy

• Won KJ
• Park JH
• Baek HJ
• Lee HL
• Zo JI

Abstract

We report a patient who suffered from bronchiolitis obliterans organizing pneumonia(BOOP) after Ivor Lewis operation for esophageal cancer. The patient presented low grade fever, dry cough and mild dyspnea at 4 day after operation. Chest roentgenograms and chest CT revealed bilateral patchy and infiltrative shadows. The respiratory symptoms worsened and respiratory failure developed with mild elevation of WBC count despite of conservative treatment. An open lung biopsy was done and the biopsy specimen showed bronchiolitis obliterans organizing pneumonia(BOOP). After several weeks of steroid therapy, there were marked clinical, physiological and roentgenographic improvements. Our experience suggests that BOOP may be one of the underlying pathology in a number of patients presenting with ARDS after thoracotomy. Since steroid therapy may improve survival in these patients, thoracic surgeons should heighten their index of suspicion for this entity. Early histologic diagnosis should be considered in patients with treatment-resistant ARDS after thoracotomy.

Keyword

Bronchiolitis obliterans organizing

MeSH Terms

Biopsy
Bronchiolitis Obliterans*
Bronchiolitis*
Cough
Cryptogenic Organizing Pneumonia*
Diagnosis
Dyspnea
Esophageal Neoplasms
Fever
Humans
Lung
Pathology
Respiratory Insufficiency
Thoracotomy*
Thorax
Tomography, X-Ray Computed