Endoscopic treatment of stenosing active tuberculosis to prevent complete bronchial occlusion: a case report and literature review

TL;DR

A 28-year-old woman with stenosing active tuberculosis was successfully treated with bronchoscopic techniques to prevent complete bronchial blockage.

Contribution

Demonstrates a minimally invasive combination of bronchoscopic treatments for managing stenosing active tuberculosis.

Findings

Combined bronchoscopic techniques achieved complete luminal patency in a patient with stenosing active tuberculosis.

No recurrence was observed during an 8-month follow-up period.

The approach offers a minimally invasive alternative to traditional surgical interventions.

Abstract

Benign central airway scar stenosis, a refractory complication of endobronchial tuberculosis and other inflammatory conditions, often leads to atelectasis, recurrent infections, and respiratory dysfunction. Traditional surgical interventions are associated with significant trauma and high restenosis rates.

This case report describes a 28-year-old female with stenosing active tuberculosis of the left upper lobe bronchus, presenting with cough, high-grade fever, and lobar collapse. The patient underwent transbronchial needle knife electrocautery for precise scar tissue dissection, followed by sequential cryoablation to suppress granulomatous proliferation and balloon dilation for airway remodeling. After five interventional bronchoscopic procedures, complete luminal patency was achieved, with no recurrence observed during 8-month follow-up.

Through this case demonstration and literature review, we highlight the clinical value of combined bronchoscopic techniques (high-frequency electrocautery, cryotherapy, and balloon dilation) in managing stenosing active tuberculosis and preventing complete bronchial occlusion, providing clinicians with a minimally invasive therapeutic alternative.

Figures