Authors' Affiliations

• Alexander Hwang - Quillen College of Medicine - East Tennessee State University • Mahmoud El Iskandarani - Quillen College of Medicine - East Tennessee State University - Department of Internal Medicine • Ibrahim Haddad - Quillen College of Medicine - East Tennessee State University - Department of Internal Medicine • Sumbal Babar - Quillen College of Medicine - East Tennessee State University - Department of Internal Medicine • Bara El Kurdi - Quillen College of Medicine - East Tennessee State University - Department of Internal Medicine

Faculty Sponsor’s Department

Internal Medicine

Name of Project's Faculty Sponsor

Dr. Jennifer Treece

Classification of First Author

Medical Student

Type

Poster: Competitive

Project's Category

Digestive System, Respiratory System, Pulmonary Diseases, Respiratory Diseases

Abstract or Artist's Statement

Acute Pancreatitis (AP) is a common disease with systemic complications, specifically pulmonary complications that are well-documented [1]. Here we present, to the best of our knowledge, the first reported case of tracheobronchomalacia as a respiratory complication of AP.

A 54-year-old white male with multiple chronic comorbidities developed necrotizing acute pancreatitis (NAP) following a surgical procedure. Internal Medicine evaluated and managed his NAP according to protocol. Within one week of NAP onset, the patient developed rapid respiratory distress. Chest radiography and ABGs were unable to diagnose ARDS. A CT scan with IV contrast was completed to investigate a pulmonary embolus and found the tracheal diameter variations during inspiration and expiration of the respiratory cycle consistent with tracheobronchomalacia (TBM). The patient’s respiratory status continued to deteriorate requiring endotracheal intubation and mechanical ventilation with weaning trials proving to be futile. The patient eventually developed fungemia and expired after his family opted for palliative extubation.

Airway collapse related to TBM is an under-recognized diagnosis which should be suspected in patients with NAP who develop acute respiratory distress in whom no specific etiology has been determined.

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Tracheobronchomalacia: An Unreported Pulmonary Complication of Acute Pancreatitis

Acute Pancreatitis (AP) is a common disease with systemic complications, specifically pulmonary complications that are well-documented [1]. Here we present, to the best of our knowledge, the first reported case of tracheobronchomalacia as a respiratory complication of AP.

A 54-year-old white male with multiple chronic comorbidities developed necrotizing acute pancreatitis (NAP) following a surgical procedure. Internal Medicine evaluated and managed his NAP according to protocol. Within one week of NAP onset, the patient developed rapid respiratory distress. Chest radiography and ABGs were unable to diagnose ARDS. A CT scan with IV contrast was completed to investigate a pulmonary embolus and found the tracheal diameter variations during inspiration and expiration of the respiratory cycle consistent with tracheobronchomalacia (TBM). The patient’s respiratory status continued to deteriorate requiring endotracheal intubation and mechanical ventilation with weaning trials proving to be futile. The patient eventually developed fungemia and expired after his family opted for palliative extubation.

Airway collapse related to TBM is an under-recognized diagnosis which should be suspected in patients with NAP who develop acute respiratory distress in whom no specific etiology has been determined.