Korean J Crit Care Med.  2012 May;27(2):115-119. 10.4266/kjccm.2012.27.2.115.

Massive Diffuse Alveolar Hemorrhage Caused by the Aspiration of Gastric Contents during Induction of Anesthesia in Patients with Adhesive Ileus: A Case Report

• Jeong JS
• Jun JH
• Song HJ
• Yoo HK

• KMID: 2228003
• DOI: http://doi.org/10.4266/kjccm.2012.27.2.115

Abstract

Aspiration pneumonitis is best defined as an acute lung injury, following the aspiration of regurgitated gastric contents. Major cause of pulmonary aspiration, during anesthesia, is gastric contents. Pulmonary aspiration can present symptoms of wheezing, coughing, dyspnea, cyanosis, pulmonary edema, hypotension, and hypoxemia, which may progress rapidly to severe acute respiratory distress syndrome (ARDS). However, there was no report of massive alveolar hemorrhage associated with aspiration pneumonitis. A 63-year-old man, who had undergone a total gastrectomy and received adjuvant chemotherapy, four months ago, was scheduled for adhesiolysis of the small bowel. The patient occurred aspiration of gastric contents, during induction of anesthesia, and subsequently, hypoxia developed during surgery. The patient moved to an intensive care unit (ICU), without extubation. Mechanical ventilation with PEEP was performed in an ICU. However, the patient died by ARDS and massive alveolar hemorrhage.

Keyword

acute respiratory distress syndrome; aspiration pneumonitis; diffuse alveolar hemorrhage

MeSH Terms

Acute Lung Injury
Adhesives
Anesthesia
Anoxia
Chemotherapy, Adjuvant
Cough
Cyanosis
Dyspnea
Gastrectomy
Hemorrhage
Humans
Hypotension
Intensive Care Units
Middle Aged
Pneumonia
Pulmonary Edema
Respiration, Artificial
Respiratory Distress Syndrome, Adult
Respiratory Sounds
Adhesives