Kumar Bahukhandi
Doctors at Kauvery Hospital performed a minimally invasive bronchoscopic procedure, using a thin, camera-equipped tube called a bronchoscope to examine and treat the airways, to diagnose and remove a tumour that had developed inside the lung airways, giving relief to a 32-year-old man who had been suffering from persistent cough for more than two months. The removal of the tumour immediately restored normal airflow and ended the patient’s cough.
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Kauvery Hospital,Tirunelveli
The patient had initially sought treatment at two other hospitals and was prescribed antibiotics, but his symptoms did not improve. At Kauvery Hospital, a chest scan revealed abnormal shadowy patches in the upper and middle parts of the left lung. A contrast-enhanced CT scan identified the underlying cause: a soft-tissue growth inside the airway blocking the airway leading to the upper part of the left lung. A detailed lung scan also showed dense lung tissue in the same region.
As the patient was not coughing up mucus from the lungs for laboratory testing, doctors performed a bronchoscopy to directly examine the airway. During the procedure, they identified a well-defined nodular growth inside the airway (endobronchial tumour). They proceeded with a specialised interventional pulmonology procedure to remove it.
The complex procedure was performed by the Department of Pulmonology, led by Dr. Adithya Vivek S and Dr. Belinda Anet, with anaesthesia support from Dr. Yogesh Kumar. Since the tumor was very vascular, a multi-disciplinary team comprising a pulmonologist, radiologist and cardiothoracic vascular surgeon was formed to provide the best possible care.
In his comments, Dr. Adithya Vivek S said, “The patient came to us with a persistent cough that had lasted nearly two months and had not improved despite antibiotic treatment. Imaging revealed a soft-tissue growth blocking the bronchus supplying the upper part of the left lung. A diagnostic bronchoscopy subsequently identified the endobronchial tumour causing complete obstruction of the left upper lobe and thereby causing post obstructive pneumonia. Endobronchial tumour resection was done with the help of bronchoscopy, a heated wire loop device (electrocautery snare) and cryotherapy. Once the obstruction was cleared, pus-like infected secretions that had accumulated behind the blockage were drained, immediately restoring normal airflow. This case underlines the need for diagnostic bronchoscopy in patients with chronic persistent cough.”
Dr. Belinda Anet commented, “In this procedure, we used several interventional bronchoscopic techniques to ensure the tumour could be removed safely while protecting the patient’s airway. We first secured the airway by placing a rigid bronchoscope to maintain airway control during the procedure. This allowed us to perform the intervention in a stable and controlled manner. We also injected medication directly into the tumour to minimise and control bleeding during removal. As an added safety measure, we placed a small balloon device (Fogarty balloon) in the left main bronchus, the main airway of the left lung, to temporarily block the passage and prevent blood from entering the rest of the airway during the procedure. These precautions helped us safely carry out the tumour removal while maintaining clear airways and stable breathing for the patient.”
Doctors pointed out that persistent cough lasting several weeks should not be ignored, as it may sometimes signal an underlying airway obstruction or other serious lung condition. Early evaluation and advanced bronchoscopic procedures can help diagnose and treat such conditions effectively.
