Newly Published
Images in Anesthesiology  |   September 2019
Tracheobronchial Polyposis after Inhalation Trauma
Author Notes
  • From the Department of Hematology, Oncology, Rheumatology and Immunology, (J.S.H.), Institute of Pathology and Neuropathology (B.F.), and Department of Medical Oncology and Pulmonology (J.H., M.H.), University Hospital Tübingen, University of Tübingen, Tübingen, Germany.
  • Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).
    Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).×
  • Correspondence: Address correspondence to Dr. Häntschel: maik.haentschel@med.uni-tuebingen.de
Article Information
Images in Anesthesiology / Respiratory System / Trauma / Burn Care
Images in Anesthesiology   |   September 2019
Tracheobronchial Polyposis after Inhalation Trauma
Anesthesiology Newly Published on September 6, 2019. doi:10.1097/ALN.0000000000002972
Anesthesiology Newly Published on September 6, 2019. doi:10.1097/ALN.0000000000002972
There is a huge variety of reasons for difficult weaning. This image represents a rare case of weaning failure, which was taken 8 weeks after admission to hospital by flexible bronchoscopy (panel A). It revealed multiple endotracheal and endobronchial polypoid lesions (arrows), accompanied by a severe bronchial edema. All parts of the bronchial tree were affected to a different degree (see video, Supplemental Digital Content, http://links.lww.com/ALN/C54).
Besides obvious burn injuries, in rare cases inhalation trauma leads to severe, obstructing tracheobronchial polyposis. Therefore, repetitive bronchoscopy should be considered based on the appearance of subsequent symptoms such as stridor, coughing, hemoptysis, wheezing, or recurrent airway infections. The stenosis of the central airways may hamper or even prevent successful weaning.