気道閉塞物に対しバルーンカテーテルを用いて内視鏡的治療を行った３症例

背景．バルーンカテーテルの使用により，容易に摘出ができた気道閉塞の３例を経験したので報告する。症例１．80歳女性。呼吸困難で受診，胸部computed tomography（CT）で左主気管支内の高濃度領域と左無気肺を認めた。気管支鏡検査で左主気管支内に粘液栓を認め，バルーンカテーテルを用いて摘出した。病理所見でアスペルギルス菌糸を認めアレルギー性気管支肺アスペルギルス症と診断した。症例２．89歳女性。食事中の呼吸困難で受診，胸部CT で左主気管支内の異物，左無気肺を認めた。気管支鏡検査で鶏肉の咀嚼物と考えられる異物を認め，バルーンカテーテルを用いて摘出した。症例３．77歳男性。呼吸困難で受診，胸部CT で左主気管支内に異物，左無気肺を認めた。気管支鏡検査でティッシュペーパーと考えられる異物を認め，バルーンカテーテルで摘出した。結論。気管支閉塞物の内視鏡的治療を行う際は，形態や性状に応じて適切なデバイスを選択する必要がある。本３症例の内視鏡治療においては，バルーンカテーテルが特に有用であった。

Background. We herein report three cases of bronchial obstruction that was easily removed using a balloon catheter. Case 1. An 80-year-old woman visited the hospital because of dyspnea. Chest computed tomography （CT） showed a high-density area in the left main bronchus and left atelectasis. Bronchoscopy revealed a mucous plug obstructing the left main bronchus and was removed using a balloon catheter. Pathological findings revealed aspergillus hyphae, and the patient was diagnosed with allergic bronchopulmonary aspergillosis. Case 2. An 89-year-old woman visited the hospital because of dyspnea during meals. Chest CT showed a foreign body in the left main bronchus and left atelectasis. Bronchoscopy revealed a foreign body, identified as chicken residue, and was removed using a balloon catheter. Case 3. A 77-year-old man visited the hospital because of dyspnea. Chest CT showed a foreign body in the left main bronchus and left atelectasis. Bronchoscopy revealed a foreign body, identified as tissue paper, and was removed using a balloon catheter. Conclusion. During bronchoscopy, an appropriate device should be selected according to the shape and properties of the bronchial obstruction. Balloon catheters were particularly useful in the bronchial endoscopic treatment of the three above mentioned cases.