Ultrasonographic view of fluid bronchogram secondary to endobronchial obstruction: A case report

Abstract

Background: Ultrasound has become an important aspect of emergency medicine due to its wide availability and portability for bedside investigations. Understanding some important ultrasound findings can aid in diagnosis and management.

Key findings: We present a case of a 65-year-old smoker who presented with shortness of breath and hemoptysis and was in respiratory failure upon arrival in the emergency department. Bedside ultrasound demonstrated a fluid bronchogram, aiding the diagnosis of lung collapse secondary to endobronchial obstruction.

Discussion: Fluid bronchograms are seen on CT chest and ultrasonography as linear images corresponding to dilated bronchus, filled with mucus, distal to an endobronchial obstruction. They are characterised by anechoic, tubular structures, suggestive of fluid filled bronchi, over the hypoechogenic pulmonary parenchyma, and can be differentiated from blood vessels by the lack of Doppler signal. Ultrasonographic image of fluid bronchogram is very unique and can help to detect collapse secondary to endobronchial obstruction using point-of-care ultrasonography in emergency.

Keywords: Endobronchial obstruction; Ultrasonography; fluid bronchogram; lung collapse.

Figure 1

(a, b) Ultrasound thorax showing fluid bronchogram in the collapsed lung. (c) CT Chest showing an endobronchial mass originating in the right upper lobe bronchus and extending into the right main bronchus, with right upper lobe collapse. (d) CT Chest showing right upper lobe collapse with fluid bronchogram secondary to endobronchial obstruction.