Undiagnosed tracheomalacia accompanied with accidental expiratory central airway collapse after tracheal intubation.
Chronic obstructive pulmonary disease
deformed trachea
emergent bronchoscopy
expiratory central airway collapse
tracheomalacia
Journal
Acute medicine & surgery
ISSN: 2052-8817
Titre abrégé: Acute Med Surg
Pays: United States
ID NLM: 101635464
Informations de publication
Date de publication:
Historique:
received:
03
02
2021
revised:
12
04
2021
accepted:
20
04
2021
entrez:
7
6
2021
pubmed:
8
6
2021
medline:
8
6
2021
Statut:
epublish
Résumé
A patient with undiagnosed tracheomalacia undergoing surgery experienced accidental expiratory central airway collapse after tracheal intubation. Here, we aimed to diagnose tracheomalacia from the preoperative data. A 73-year-old man, scheduled for abdominal surgery, had a clinical history of chronic obstructive pulmonary disease. Preoperative chest computed tomography revealed a lateral narrowing of the tracheal shape. After tracheal intubation, we could not manually ventilate the inflated lung. Emergent bronchoscopy findings, including severe expiratory tracheal collapse, indicated a diagnosis of tracheomalacia. We could fully ventilate the patient by moving the endotracheal tube near the tracheal carina and finally changing it to a double-lumen tube. Airway collapse did not occur under spontaneous breathing. Accidental expiratory central airway collapse could occur in patients with undiagnosed tracheomalacia during surgery. A diagnosis of tracheomalacia should be presumed from a deformed trachea on preoperative imaging and history of chronic obstructive pulmonary disease.
Sections du résumé
BACKGROUND
BACKGROUND
A patient with undiagnosed tracheomalacia undergoing surgery experienced accidental expiratory central airway collapse after tracheal intubation. Here, we aimed to diagnose tracheomalacia from the preoperative data.
CASE PRESENTATION
METHODS
A 73-year-old man, scheduled for abdominal surgery, had a clinical history of chronic obstructive pulmonary disease. Preoperative chest computed tomography revealed a lateral narrowing of the tracheal shape. After tracheal intubation, we could not manually ventilate the inflated lung. Emergent bronchoscopy findings, including severe expiratory tracheal collapse, indicated a diagnosis of tracheomalacia. We could fully ventilate the patient by moving the endotracheal tube near the tracheal carina and finally changing it to a double-lumen tube. Airway collapse did not occur under spontaneous breathing.
CONCLUSION
CONCLUSIONS
Accidental expiratory central airway collapse could occur in patients with undiagnosed tracheomalacia during surgery. A diagnosis of tracheomalacia should be presumed from a deformed trachea on preoperative imaging and history of chronic obstructive pulmonary disease.
Identifiants
pubmed: 34094584
doi: 10.1002/ams2.665
pii: AMS2665
pmc: PMC8157476
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e665Informations de copyright
© 2021 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine.
Déclaration de conflit d'intérêts
Approval of the research protocol: N/A. Informed consent: Verbal and written informed consent was obtained from the patient. Registry and registration no. of the study/trial: N/A. Animal studies: N/A. Conflict of interest: None.
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