High Resolution Computerized Tomography of Chest in Patients Exposed to Sulfur Mustard

Background/Objectives: Pulmonary complications are known to occur in over half of the patients exposed to sulfur mustard (SM). Chemical weapon agents (CWA) including SM were used by Iraq during Iran-Iraq war between 1983 and 1989. We undertook a retrospective analysis of the patients with documented exposure to SM during the war who subsequently developed respiratory symptoms. A review of the chest High Resolution Computed Tomography (HRCT) findings was performed to determine the features of this disease defined by this diagnostic modality. Materials and Method: Field documents and other medical records of 155 patients exposed to SM during Iran-Iraq war and suffered respiratory complications were studied. The chest HRCTs of these patients were reviewed in order to determine the delayed radiographic patterns in patients with documented exposure to SM. Results: Fifty chest HRCTs of these patients were evaluated. The most frequent findings were; air trapping 38 (76%), bronchiectasis 37 (74%), mosaic parenchymal attenuation (MPA) 36 (72%), major airway dilatation 33 (66%) and secondary lobule abnormalities 13 (26%) respectively. Conclusions: Exposure to SM has devastating chronic pulmonary complications potentially disabling those affected severely. Chest HRCT findings of bronchiectasis, air trapping, major airway abnormalities, and EMPA are frequently observed in patients exposed to SM. These findings are highly suggestive of constrictive bronchiolitis obliterans (BO) diagnosis.