Suffocation from Balloon Bronchoplasty

Jorge L. Morales-Estrella, Michael MacHuzak, Bohdan Pichurko, Hanine Inaty, Atul C. Mehta

Research output: Contribution to journalArticlepeer-review


Negative pressure pulmonary edema is a well-described complication of upper airway obstruction. However, the simultaneous occurrence of blood-stained secretions and petechial tracheobronchial hemorrhage are rarely recognized and a potential complication of transient intentional occlusion of the airways. We described a case of hemorrhagic bronchial mucosa syndrome and asymptomatic blood-tinged pulmonary edema after balloon bronchoplasty for a concentric tracheal stenosis using a flexible bronchoscopy. This was characterized by interval appearance of diffuse petechial tracheobronchial bleeding and a persistent blood-tinged alveolar effluent after sustained occlusion of the airway. The simultaneous occurrence of both phenomena in this patient suggests different degrees of injury in a common pathogenic spectrum. We postulate that sustained, complete occlusion of the airway produces variable degrees of mechanical disruption of the bronchial and alveolar vasculature that lead to the development of negative pressure pulmonary edema and tracheobronchial hemorrhage. In this case, the syndrome was self-limited and without major consequences but highlights an unrecognized potential complication of balloon bronchoplasty.

Original languageEnglish (US)
Pages (from-to)156-160
Number of pages5
JournalJournal of Bronchology and Interventional Pulmonology
Issue number2
StatePublished - 2018
Externally publishedYes


  • airway obstruction
  • asphyxia
  • hemorrhage
  • pulmonary edema
  • tracheal stenosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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