The patient had initially sought medical attention at two other hospitals where he was prescribed antibiotics; however, his condition failed to improve. Upon his arrival at Kauvery Hospital, Tirunelveli, a chest scan revealed abnormal shadowy patches in the upper and middle sections of the left lung. Subsequent investigation through a contrast-enhanced CT scan identified the underlying cause as a soft-tissue growth located inside the airway, which was obstructing the passage leading to the upper part of the left lung. A detailed lung scan further confirmed the presence of dense lung tissue in the affected region.
Because the patient was unable to produce mucus for laboratory testing, the medical team elected to perform a bronchoscopy for direct visualization. During this diagnostic phase, surgeons identified a well-defined nodular growth, or endobronchial tumour, within the airway. Given the vascular nature of the tumour, a multi-disciplinary team was organized to ensure the highest standard of care, comprising pulmonologists, a radiologist, and a cardiothoracic vascular surgeon. The procedure was executed by the Department of Pulmonology, led by Dr. Adithya Vivek S and Dr. Belinda Anet, with anaesthesia support provided by Dr. Yogesh Kumar.
Dr. Adithya Vivek S explained that the diagnostic bronchoscopy revealed the tumour was causing a complete obstruction of the left upper lobe, resulting in post-obstructive pneumonia. The surgical team utilized an interventional pulmonology approach, employing a heated wire loop device known as an electrocautery snare alongside cryotherapy to resect the tumour. Following the clearance of the obstruction, pus-like infected secretions that had accumulated behind the blockage were successfully drained, immediately restoring the patient's ability to breathe normally.
Describing the technical safety measures, Dr. Belinda Anet noted that the team first secured the airway by placing a rigid bronchoscope to maintain control throughout the intervention. Medication was injected directly into the tumour to minimize bleeding, and a Fogarty balloon was placed in the left main bronchus as an added precaution to prevent blood from entering the rest of the airway. These specialized techniques allowed the team to safely carry out the resection while maintaining stable breathing for the patient. This successful case highlights the critical necessity of diagnostic bronchoscopy for patients suffering from chronic, persistent coughs, as early evaluation of such symptoms can reveal serious underlying airway obstructions.
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