Tuberc Respir Dis.  2015 Jul;78(3):286-288. 10.4046/trd.2015.78.3.286.

Fistula Formation between Right Upper Bronchus and Bronchus Intermedius Caused by Endobronchial Tuberculosis: A Case Report

• Kim M
• Kang ES
• Park JY
• Kang HR
• Kim JH
• Chang Y
• Choi KH
• Lee KM
• Kim Y
• An JY

• KMID: 2320658
• DOI: http://doi.org/10.4046/trd.2015.78.3.286

Abstract

Endobronchial tuberculosis is defined as a tuberculous infection of the tracheobronchial tree and has a prevalence of up to 50% in active pulmonary tuberculosis cases. The most common complication of endobronchial tuberculosis is bronchial stenosis; benign fistula formation by endobronchial tuberculosis is rare, especially inter-bronchial fistula formation. We reported a rare case of a 73-year-old woman with a fistula between the right upper bronchus and bronchus intermedius. A diagnosis of inter-bronchial fistula caused by endobronchial tuberculosis was based on the results of chest computed tomography scans, bronchoscopy, and microbiological and pathological tests. The patient was treated with anti-tuberculous medication, and her symptoms gradually improved.

Keyword

Tuberculosis; Fistula; Tomography, X-Ray Computed; Bronchoscopes

MeSH Terms

Aged
Bronchi*
Bronchoscopes
Bronchoscopy
Constriction, Pathologic
Diagnosis
Female
Fistula*
Humans
Prevalence
Thorax
Tomography, X-Ray Computed
Tuberculosis*
Tuberculosis, Pulmonary

Figure

• 

  Figure 1 A chest radiograph revealed an ill-defined consolidation in the right lower lung fields and fibrotic change in the right upper lung fields.

• 

  Figure 2 (A) Coronal image of the chest obtained using computed tomography (CT) scan revealed multiple variable-sized mediastinal lymph nodes. (B) Sagittal image of chest obtained using CT scan showed the whole pathway of the broncho-bronchial fistula, which originated in the right upper lobe bronchus and inserted in the bronchus intermedius. (C) The volume rendering image showed the presence of a fistula between the right upper lobe bronchus and the bronchus intermedius. RULB: right upper lobe bronchus; BI: bronchus intermedius; RMLB: right middle lobe bronchus.

• 

  Figure 3 (A) A round bronchial wall defect of approximately 3 mm was found at the anterior wall of the right upper lobar bronchus. (B) A round bronchial wall defect of approximately 3 mm was found at the lateral aspect of the distal bronchus intermedius. RULB: right upper lobe bronchus; RLLB: right lower lobe bronchus; RMLB: right middle lobe bronchus.

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