Korean J Anesthesiol.  2003 Aug;45(2):290-292. 10.4097/kjae.2003.45.2.290.

Iatrogenic Aspiration of a Broken Stylet Detected by Cough

• Lim YS
• Yoon GB
• Park GS
• Lim HK

• KMID: 2236730
• DOI: http://doi.org/10.4097/kjae.2003.45.2.290

Abstract

Complications related to a broken stylet during endotracheal intubation have been infrequently reported. In most cases, broken stylets have been recognized by chest radiography. We report a case of unrecognized iatrogenic aspiration of a broken stylet. A 37-year-old man, who underwent explo-laparotomy two days previously, was reintubated with an uncoated stylet in the intensive care unit because of dyspnea and pulmonary congestion. He was on artificial ventilation for one day and was extubated one week later. We could not find the broken stylet on serial chest x-ray films until a metallic substance was expectorated while the patient was coughing 28 days after extubation. During the intervening period the patient did not complain of any chest discomfort and we did not realize that the broken stylet remained. The use of a plastic coated stylet and its careful observation after intubation are recommended to avoid this complication.

Keyword

complication; intubation; stylet

MeSH Terms

Adult
Cough*
Dyspnea
Estrogens, Conjugated (USP)
Humans
Intensive Care Units
Intubation
Intubation, Intratracheal
Plastics
Radiography
Thorax
Ventilation
X-Ray Film
Estrogens, Conjugated (USP)
Plastics