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KMID : 0370920070240020344
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Yeungnam Univercity Journal of Medicine
2007 Volume.24 No. 2 p.344 ~ p.350
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Subcutaneous Emphysema and Inflammation of the Neck after Tracheal Puncture by an Intubating Stylet
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Jung Gul
Byun Woo-Mok
Lim Hyung-Jun
Kim Jong-Gyun
Kwak Dong-Min
Lee Deok-Hee
Kim Sae-Yeon
Song Sun-Ok
Seo Il-Sook
Jee Dae-Lim
Kim Heung-Dae
Park Dae-Pal
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Abstract
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Laryngo-tracheal perforation caused by the use of a stylet during tracheal intubation is a rare complication. We present a case of subcutaneous emphysema and connective tissue inflammation after tracheal intubation. The patient was a 41-year-old male undergoing general anesthesia for an appendectomy. The intubation was difficult during laryngoscopy (Cormack- Lehane Grade III). An assistant provided an endotracheal tube with a stylet inside while the laryngoscope was in place. During intubation, a short, dull sound was heard with a sudden loss of resistance after the distal tip of the endotracheal tube passed the rima glottis. A sonogram and computerized tomography revealed subcutaneous emphysema from the neck to the upper mediastinum and fluid collection between the trachea and the thyroid. This lesion appeared to have been caused by the protruded, loose stylet. Anesthesiologists should be aware of the damage a loose stylet protruding beyond the tip of the endotracheal tube can cause.
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KEYWORD
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Tracheal Injury, Intubation, Subcutaneous Emphysema
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