Humble Foley's catheter to the rescue in a case of T-tube insertion: a case report

Abstract

The Montgomery T-tube poses a challenge to anesthesiologists because of loss of anesthetic gases through the open proximal end of the vertical limb and lack of standard anesthesia circuit connectors. Here, we present a case of a 25-year-old woman with a reported history of accidental strangulation 18 months previously. The patient had a metallic tracheostomy tube in situ due to the development of tracheal stenosis. Computed tomography showed significant narrowing in a 7-8-mm segment, 2 cm proximal to the tracheostomy tube in situ. She was scheduled for tracheal reconstruction surgery and T-tube insertion due to persistent subglottic stenosis. In this case, the Foley's catheter, which was inserted into the glottis orally, not only aided easy insertion of the T-tube into the trachea through the tracheal stoma, but also enabled us to stop the loss of anesthetic gases through the proximal vertical limb of the T-tube.

Keywords: Foley's catheter; T-tube; Tracheal stenosis.

Fig. 1. (A) Lateral view X-ray of the neck and (B) non-contrast computed tomography (NCCT) scan showing subglottic stenosis.

Fig. 2. Intraoperative images showing Foley's catheter and T-tube.