Tracheal Compression by the Stomach Following Gastric Pull-Up Kim Suil , MD, PhD, Gotway Michael B. , MD, Webb W. Richard , MD, Gordon Roy L. , MD, Golden Jeffrey A. , MD  CHEST  Volume 121, Issue 3, Pages 998-1001 (March 2002) DOI: 10.1378/chest.121.3.998 Copyright © 2002 The American College of Chest Physicians Terms and Conditions

Figure 1 Flow-volume loop before and after expandable metal stent placement. Loop (a) demonstrates severely decreased expiratory flows and a plateau appearance. After stent placement, loop (b) reveals increased flows and a more normal-appearing contour. CHEST 2002 121, 998-1001DOI: (10.1378/chest.121.3.998) Copyright © 2002 The American College of Chest Physicians Terms and Conditions

Figure 2 An axial image from a helical chest CT examination photographed in soft-tissue windows (width, 440 Hounsfield units [HU]; level, 40 HU) that was performed during full inspiration demonstrates an 8-mm tracheal lumen (arrow). The trachea is compressed between the innominate artery anteriorly (arrowhead) and the intrathoracic stomach posteriorly and medially (curved arrow). CHEST 2002 121, 998-1001DOI: (10.1378/chest.121.3.998) Copyright © 2002 The American College of Chest Physicians Terms and Conditions

Figure 3 An axial image from a chest CT examination (window width, 440 HU; level, 40 HU) that was performed during an FVC maneuver, without table increment, at the point of maximal tracheal narrowing, as determined on the inspiratory study. The tracheal lumen (arrow) decreased in caliber from 8 mm on the inspiratory study to 4 mm on this dynamic study, indicating the presence of tracheomalacia in addition to narrowing from extrinsic compression. See the legend to Figure 2 for abbreviations not used in the text. CHEST 2002 121, 998-1001DOI: (10.1378/chest.121.3.998) Copyright © 2002 The American College of Chest Physicians Terms and Conditions

Figure 4 An axial image from a chest CT examination (window width, 440 HU; level, 40 HU) following the endoluminal placement of an expandable metallic stent, which was performed during an FVC maneuver, reveals a patent trachea with a lumen of normal caliber (arrow). Some granulation tissue is visible within the internal diameter of the stent. No evidence of dynamic collapse is noted. See the legend to Figure 2 for abbreviations not used in the text. CHEST 2002 121, 998-1001DOI: (10.1378/chest.121.3.998) Copyright © 2002 The American College of Chest Physicians Terms and Conditions