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Isolated left main bronchus compression in children identified with bronchoscopy
Thesis (MMed)--Stellenbosch University, 2023.
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| Other Authors: | |
| Format: | Thesis |
| Language: | en_ZA en_ZA |
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Stellenbosch : Stellenbosch University
2023
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| _version_ | 1867613927051886592 |
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| access_status_str | Open Access |
| author | Barker, Larissa |
| author2 | Goussard, Pierre |
| author_browse | Barker, Larissa Goussard, Pierre |
| author_facet | Goussard, Pierre Barker, Larissa |
| author_sort | Barker, Larissa |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MMed)--Stellenbosch University, 2023. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/128881 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA en_ZA |
| last_indexed | 2026-06-10T12:43:54.909Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/128881 Isolated left main bronchus compression in children identified with bronchoscopy Barker, Larissa Goussard, Pierre Van Wyk, Lizelle Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health. Bronchoscopy Respiratory organs -- Obstructions Vascular compression Thesis (MMed)--Stellenbosch University, 2023. ENGLISH ABSTRACT: Background: Vascular compression of the paediatric airway, particularly the left main bronchus (LMB), is often associated with congenital cardiac disease. However, cases of LMB compression unrelated to cardiac pathology are rare. This study aims to investigate the aetiology, clinical presentations, and imaging findings of children with isolated LMB compression. Methods: A retrospective analysis of bronchoscopy data was conducted on children (n = 100) aged 3 months to 12 years who underwent bronchoscopy between January 2018 and June 2023. The study included all children with left main bronchus (LMB) compression and persistent respiratory symptoms identified during bronchoscopy. The respiratory symptoms included recurrent wheezing, recurrent infections, clinically significant airway obstruction, or a combination of these. Clinically significant airway obstruction on high-quality chest X-rays (CXR) was defined as clear narrowing of the trachea or one of the main bronchi. Bronchoscopy was performed under general anaesthesia with systematic assessment of airway obstructions and grading of LMB compression. Further diagnostic tests included bronchoalveolar lavage (BAL), imaging findings and echocardiography. Results: Isolated LMB compression was identified in 9.6% of the bronchoscopy cases. The most common indications for bronchoscopy were recurrent pneumonia (73%) and recurrent wheezing (31%). Dual symptoms were present in 4% (n = 4). CXR revealed abnormalities in 85% of cases, including hyperlucent left lung (29%) and LMB nonvisibility (49%). Aetiology of LMB compression was attributed to vascular compression (48%), tuberculosis (TB) (50%), and other causes (2%). Vascular compression of the LMB is due to compression between decending aorta and proximal left pulmonary artery. Neutrophilic airway inflammation was observed in both vascular and nonvascular compression cases. Viral co-infections were common (85%) with CMV and adenovirus being predominant. Conclusion: Isolated LMB compression in paediatric patients can result from vascular compression or TB. Bronchoscopy plays a crucial role in diagnosing and characterizing airway compression, especially when associated with recurrent respiratory symptoms and abnormal chest X-rays. Vascular compression cases tend to exhibit more severe obstruction on bronchoscopy, while lymphadenopathy may contribute to non-vascular compression. Viral co-infections are prevalent in children with large airway pathology. This study highlights the importance of bronchoscopy as a diagnostic tool in paediatric patients with persistent respiratory symptoms and provides insights into the diverse aetiologies of LMB compression. AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar. Masters 2023-11-25T12:45:44Z 2024-01-08T14:26:00Z 2023-11-25T12:45:44Z 2024-01-08T14:26:00Z 2023-11 Thesis https://scholar.sun.ac.za/handle/10019.1/128881 en_ZA en_ZA Stellenbosch University 22 pages application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Bronchoscopy Respiratory organs -- Obstructions Vascular compression Barker, Larissa Isolated left main bronchus compression in children identified with bronchoscopy |
| title | Isolated left main bronchus compression in children identified with bronchoscopy |
| title_full | Isolated left main bronchus compression in children identified with bronchoscopy |
| title_fullStr | Isolated left main bronchus compression in children identified with bronchoscopy |
| title_full_unstemmed | Isolated left main bronchus compression in children identified with bronchoscopy |
| title_short | Isolated left main bronchus compression in children identified with bronchoscopy |
| title_sort | isolated left main bronchus compression in children identified with bronchoscopy |
| topic | Bronchoscopy Respiratory organs -- Obstructions Vascular compression |
| url | https://scholar.sun.ac.za/handle/10019.1/128881 |
| work_keys_str_mv | AT barkerlarissa isolatedleftmainbronchuscompressioninchildrenidentifiedwithbronchoscopy |