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KMID : 1155520180130040463
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Anesthesia and Pain Medicine
2018 Volume.13 No. 4 p.463 ~ p.467
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Pharyngeal reperforation following incentive spirometry - A case report -
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Jeon So-Eun
Hong Jeong-Min
Kwon Jae-Young
Hwang Boo-Young
Yun Gi-Young
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Abstract
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Despite its widespread use, complication of incentive spirometry has been rarely reported. We report a case of pharyngeal reperforation following incentive spirometry. A 75-year-old female, had a history of long-term steroid use, entered the intensive care unit for maintenance of mechanical ventilation following surgical repair of a pharyngeal perforation. After ventilator weaning, incentive spirometry was implemented on postoperative day 4. Immediately after incentive spirometry use, patient’s neck began to swell, and subcutaneous emphysema was palpated. Pharyngeal reperforation was suspected on neck computed tomography, and emergency surgery was performed. Surgery revealed a 3-cm long rupture from the hypopharynx to the esophagus. The causes were thought to be delayed wound healing due to long-term steroid use and a sudden increase in pharyngeal pressure due to incentive spirometry. In conclusion, particular attention should be paid when using incentive spirometry after head and neck surgery in patients with a history of long-term steroid use.
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KEYWORD
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Head and neck surgery, Incentive spirometer, Incentive spirometry, Pharyngeal perforation, Steroids
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