Korean J Anesthesiol.  2010 Dec;59(Suppl):S13-S16. 10.4097/kjae.2010.59.S.S13.

Anesthetic experience of an adult patient with an unrecognized tracheal bronchus: A case report

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, College of Medicine, Yonsei University, Seoul, Korea. jhanes@yuhs.ac.kr
  • 2Anesthesia and Pain Research Institute, College of Medicine, Yonsei University, Seoul, Korea.

Abstract

We present a case of problematic tracheal intubation in an adult patient with an unrecognized tracheal bronchus. Immediately after tracheal intubation and position change to prone, bilateral breath sounds were almost absent, and there was a diminished tidal volume. In order to resolve the ventilatory difficulty, the wire-reinforced tube was replaced with a conventional tube, and proper positioning of the tube was completed under fiberoptic guidance. A tracheal bronchus (originating about 1.2 cm above the carina, and supplying the right upper lobe) was found on the postoperative chest CT. In the presence of tracheal bronchus, tracheal intubation may cause pulmonary complications. Anesthesiologists should keep in mind the anesthetic implications of tracheal bronchus, and must be familiar with the use of fiberoptic bronchoscopy for proper positioning of endotracheal tube.

Keyword

Endotracheal intubation; Tracheal bronchus

MeSH Terms

Adult
Bronchi
Bronchoscopy
Humans
Intubation
Intubation, Intratracheal
Thorax
Tidal Volume
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