Aspiration Pneumonitis Occurring during General Anesthesia in a Parturient with Strangulation Ileus: A case report / 대한마취과학회지

ABSTRACT

Pulmonary aspiration of gastric contents is the main cause of anesthesia-related maternal deaths. We experienced a case of pulmonary aspiration during induction of general anesthesia for an emergency cesarean section. The parturient was admitted for severe abdominal pain and abnormal fetal movement. She had no remarkable past medical history except for an appendectomy, 3 years earlier. The massive pulmonary aspiration of acid-liquid, malodorous feculent, gastric contents occurred accidently. Immediate endotracheal intubation and suction were followed. The strangulation ileus of the small bowel resulting from the pressure of the enlarged uterus on intestinal adhesions was detected after cesarean delivery and severe pulmonary edema developed during the perioperative period. Intensive care including mechanical ventilation with positive end-expiratory pressure, frequent suction, antibiotic therapy and other measures was attempted. At the 50th day after the operation the patient was discharged fortunately without any meaningful pulmonary sequelae. In conclusion, we should be aware of the possibility of mechanical ileus and pulmonary aspiration in parturients with past abdominal operation histories during anesthesia for cesarean section.