[Tracheobronchial lesions due to anesthetic procedures. Report of 2 cases].
We have reviewed 48.000 patients who underwent surgery with general anesthesia in our department during the last 12 years. We have found 14 cases of tracheal rupture (2.9%). In 7 cases (1.4%) rupture was due to direct trauma or laceration at the thorax or neck; in 5 patients (1.04%) it was produced by steel blade or firearm; and in the remaining 2 cases (0.4%) tracheal rupture was produced during anesthesia. In one of these two patients rupture was produced by a double lumen Carlens tube used during a right thoracotomy. This patient had previous history of pulmonary tuberculosis and chronic bronchitis. Tracheal rupture occurred at the end of the surgical procedure coinciding with a displacement of the endotracheal tube and was suspected because the presence of air escape. It was verified by exploring the mediastinal pleura. Due to the rapid diagnosis and prompt repair the lesion had no clinical consequences and the surgical intervention was successfully completed. The second patient underwent a diagnostic laparomy and presented tracheal rupture due to severe bronchospasm during and apparently normal intubation procedure. The moment at which the tracheal lesion occurred was unnoticed and the patient suffered a progressive ventilatory deterioration requiring reanimation procedures to preserve the hemodynamic status and to restore blood oxygen concentration and to compensate blood acidoses. Tracheal rupture was repaired during a second intervention and was followed by a clinical recovery. However the patient died later due to a complication unrelated to the anestethetic technique.(ABSTRACT TRUNCATED AT 250 WORDS)
Lobo Sánchez
M
M
Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital de la Paz, Universidad Autónoma, Madrid.
Reinaldo Lapuerta
J A
JA
Tamame Tamame
C
C
Reinoso Barbero
F
F
Girón Montáñez
R
R
D000770:Anesthesia, Endotracheal / Q000009:adverse effects*; D001980:Bronchi / Q000293:injuries*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D008297:Male; D008875:Middle Aged; D014132:Trachea / Q000293:injuries*
Lesiones traqueobronquiales debidas a procedimientos anestésicos. A propósito de 2 casos.