Anesth Pain Med.  2024 Jul;19(3):261-265. 10.17085/apm.23108.

Gastric distension and atelectasis after using a supraglottic airway - A case report -

• Jung Y
• Jung S
• Yu S
• Jeong MA
• Kim CL

• KMID: 2563567
• DOI: http://doi.org/10.17085/apm.23108

Abstract

Background
Supraglottic airways (SGAs) are used during general anesthesia (GA) due to comfort. Certain complications are possible, such as gastric distension. The incidence of pulmonary aspiration of regurgitated gastric contents was found to be 0.02%. A difference in the incidence of gastric regurgitation was not identified between the use of SGAs and endotracheal intubation. We report a case of gastric distension and atelectasis in a patient in whom an I-gel® was used for GA. Case: A 63-year-old female patient underwent triple arthrodesis on her ankle under GA using an SGA (I-gel® size 3). After surgery, she suffered from nausea and abdominal bloating. A chest radiograph revealed that a large amount of air in her stomach had caused gastric distention, which resulted in left hemidiaphragm elevation and atelectasis.
Conclusions
This case illustrates that the use of I-gel® in prolonged surgeries may result in malposition of the SGA and gastric insufflation and atelectasis.

Keyword

Airway management; Endotracheal intubation; Gastric regurgitation; General anesthesia; Laryngeal mask; Stomach

Figure

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  Fig. 1. Chest radiographs. (A) A preoperative chest antero-posterior (AP) radiograph taken 2 weeks before surgery shows no abnormal findings other than bronchiectasis. (B) A postoperative chest AP radiograph image obtained a few hours after surgery shows gastric distension, left hemidiaphragm elevation, and left lower-lobe atelectasis. (C) A postoperative chest AP radiograph image taken 1 day after surgery shows left hemidiaphragm elevation.

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