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. 2011 Apr;60(4):285-9.
doi: 10.4097/kjae.2011.60.4.285. Epub 2011 Apr 26.

Tracheal laceration during intubation of a double-lumen tube and intraoperative fiberoptic bronchoscopic evaluation through an LMA in the lateral position -A case report-

Joohee Kim  1 , Taewan Lim, Jae-Hyon Bahk
Affiliations

Tracheal laceration during intubation of a double-lumen tube and intraoperative fiberoptic bronchoscopic evaluation through an LMA in the lateral position -A case report-

Joohee Kim et al. Korean J Anesthesiol. 2011 Apr.

Abstract

A 76-year-old, 148-cm woman was scheduled for right upper lobectomy. A 32 Fr left-sided double lumen tube was placed using a conventional technique. Despite several attempts under fiberoptic bronchoscope-guidance, we could not locate the double lumen tube properly. We thus decided to proceed with the bronchial tube in the right mainstem bronchus. During surgery, 8-cm-long laceration was noted on the posterolateral side of the trachea. To check the possibility of laceration of the proximal trachea, the double lumen tube was changed to an LMA for use as a conduit for fiberoptic bronchoscopic evaluation in the lateral position. A plain endotracheal tube with the cuff modified and collapsed was re-intubated after evaluation. And then she was transferred to SICU.

Keywords: Fiberoptic bronchoscope; Intubation; LMA; Laceration; Trachea.

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Figures

Fig. 1
Fig. 1
The preoperative chest X-ray shows the tracheal deviation to the right side.
Fig. 2
Fig. 2
The preoperative chest computed tomography scan. (A) the diameter of the right main bronchus, 12.5 mm. (B) the diameter of left main bronchus, 8.6 mm.
Fig. 3
Fig. 3
The cuff of an internal diameter 7.0 mm endotracheal tube was modified during deflation to make a frill-like fold (arrows) at the proximal end.
See this image and copyright information in PMC

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