ABSTRACT
Tracheal rupture is an infrequent complication with high morbidity and mortality, of multifactorial etiology, being orotracheal intubation its main cause. Spontaneous tracheal rupture usually occurs after severe coughing and/or vomiting over a weakened trachea. The diagnosis is non-specific, based on highly suggestive signs and symptoms such as subcutaneous emphysema, pneumomediastinum and respiratory distress, and its confirmation requires the performance of a bronchoscopy. The location and extent of the rupture determines the clinic. This implies the importance of an early diagnosis to avoid a poor prognosis. We present the case of an elderly male patient with a spontaneous tracheal rupture without apparent cause
La rotura traqueal es una complicación infrecuente de etiología multifactorial, con una elevada morbimortalidad, la intubación orotraqueal es su principal causa. La rotura traqueal espontánea suele producirse luego de toser o presentar vómitos intensos, sobre una tráquea debilitada. El diagnóstico es inespecífico, se basa en signos y síntomas altamente sugestivos como enfisema subcutáneo, neumomediastínico y dificultad respiratoria y su confirmación exige la realización de una broncoscopia. La localización y extensión de la rotura determinan la clínica. Esto implica la importancia del diagnóstico precoz para evitar un pronóstico infausto. Se presenta el caso de un paciente varón, de edad avanzada. con una rotura espontánea traqueal sin causa aparente
Subject(s)
Humans , Male , Aged, 80 and over , Trachea , Tracheal Diseases , Neck Injuries , Dyspnea , Rupture, SpontaneousABSTRACT
We report on a case of difficult endotracheal intubation in a patient with marked tracheal deviation at an angle of 90 degrees combined with stenosis due to kyphoscoliosis with vertebral body fusion. After induction of general anesthesia, a proper laryngeal view was easily obtained using a videolaryngoscope. But a tracheal tube could not be advanced more than 3 cm beyond the vocal cords due to resistance, despite various attempts, including the use of small size tubes, full rotation of the tube tip, and fiberoptic bronchoscopy. Ultimately, the airway was successfully secured by placing a tube tip above the area of resistance and by additionally packing saline-soaked gauzes around the tracheal inlet to minimize gas leakage and to fasten the tube in the trachea.
Subject(s)
Humans , Anesthesia, General , Bays , Bronchoscopy , Constriction, Pathologic , Intubation , Intubation, Intratracheal , Kyphosis , Scoliosis , Trachea , Tracheal Diseases , Vocal CordsABSTRACT
Objective To discuss the technical points and the clinical application of single wire-guided inverted Y-shaped tracheal stent implantation under general anesthesia in treating complex tracheal diseases. Methods During the period from January 2014 to October 2014 at authors’ hospital, a total of 6 patients with complex tracheal diseases received inverted Y-shaped tracheal stent implantation. The diseases included trachea-pleural fistula(n=1), trachea-esophageal fistula(n=2) and complex tracheal stenosis(n=3). Under general anesthesia and guided by DSA, inverted Y-shaped tracheal stent implantation was carried out in all the 6 patients. The results were analyzed. Results A total of 6 Y-shaped tracheal stents were used in the 6 patients, and single wire-guided implantation technique was employed in all procedures. In one case , the right branch of the Y-shaped tracheal stent was placed in the right upper lobe bronchus by mistake , and in the remaining 5 cases the stent implantation was successfully accomplished with single manipulation. Conclusion Under general anesthesia, Y-shaped tracheal stent implantation can effectively obstruct the trachea-pleural fistula and left main bronchus-esophageal fistula, and it can also quickly and significantly relieve the complex airway stenosis located at the tracheal carina region. This treatment is safe and reliable with satisfactory short-term effect. Moreover, single wire-guided manipulation is technically simpler, easier and faster than dual wire-guided manipulation. Therefore, this technique should be recommended in the clinical practice.
ABSTRACT
Traqueobronquite aguda é uma forma rara da aspergilose invasiva e geralmente ocorre em pacientes com imunodepressão grave. Relatamos o caso de um paciente no pós-transplante de medula óssea com a manifestação desta doença, dando ênfase aos achados tomográficos encontrados.
Acute tracheobronchitis is a rare manifestation of invasive aspergillosis, generally occurring in severely immunocompromised patients. The authors report the case of a patient presenting with this condition after bone-marrow transplantation, with emphasis on tomographic findings.
ABSTRACT
Tracheobronchomegaly or Mounier-Kuhn syndrome a is rare disease characterized by marked dilatation of the trachea and main bronchi. It is thought to be due to a congenital anomaly, but is uncertain. It has variable clinical manifestations from causing chronic respiratory infections and bronchiectasis to being asymptomatic for the lifetime. Recently, we experienced a case of Mounier-Kuhn syndrome patient with tracheal diverticulum, who had lung cancer. Our case is reported with literature reviews.