Radiation therapy and mechanical dilation of endobronchial obstruction secondary to Wegener's granulomatosis.

A patient with Wegener's granulomatosis, which was otherwise well controlled with steroids and cyclophosphamide, had persistent total obstruction of an inflamed left mainstem bronchus. The inflammation resolved, and the lung expanded following radiation therapy. However, intermittent atelectasis and pneumonia occurred distal to a residual short stricture. Repeated dilation endoscopically with Plummer bougies has proven effective in maintaining good ventilation and preventing recurrence of the atelectasis and pneumonia in the left lung for 18 months.