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KMID : 0352120170320010058
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Journal of Kyung Hee University
2017 Volume.32 No. 1 p.58 ~ p.62
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Anesthetic Management in a Patient with a Tracheal Diverticulum: A Case Report
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Song Keulame
Kim Ji-A
Ryu Kyoung-Ho
Cho Eun-Ah
Choi Won-Jun
Kim Yun-Hong
Kim Hyun-Soo
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Abstract
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Tracheal diverticulum (TD) could cause difficult tracheal intubation or ventilation. It is also associated with critical complications such as pneumomediastinum during general anesthesia. We report successful anesthetic management of a patient with a TD using a flexible fiberoptic bronchoscope. A 70-year-old man was scheduled for laparoscopic colorectal surgery. Preoperative chest computed tomography revealed the TD located 7 cm cephalad to the carina. To confirm the location of the TD, bronchoscope-guided tracheal intubation was planned. After induction of general anesthesia, the location of the TD was confirmed using a bronchoscope and a 7.5-mm inner diameter endotracheal tube was advanced distally more than the standard position so that the balloon of the endo tracheal tube could pass beyond the opening of the TD. This process enabled isolation of the TD from the positive pressure of mechanical ventilation. The surgery was subsequently completed with no ventilatory disturbance or hemodynamic instability.
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KEYWORD
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Fiberoptic bronchoscope, Tracheal diverticulum
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