title: [Aspiration pneumonia during the endotracheal intubation on the occasion of bladder perforation by TUR].
abstract: We report on two cases of aspiration pneumonia which developed during the endotracheal intubation after bladder perforation during TUR. The first case was a 79 y.o. male, who underwent TUR-P and lithotripsy under spinal and epidural anesthesia. The second case was a 69 y.o. male, who had undergone TUR-Bt under nitrous oxide-oxygen-enflurane anesthesia. General anesthesia was selected to perform an laparotomy when the diagnosis was made. They vomited a considerable amount of gastric content just after giving the drugs for induction. The chest X-rays revealed signs of aspiration pneumonia. These X-ray findings improved in a week using antibiotic therapy. Although TUR is performed as scheduled, vomiting may occur in the case of unexpected bladder perforation, which can cause aspiration pneumonia. In such emergency, we should insert a nasal tube before induction, press the cricoid (crush induction), or intubate with the patient awake.
authors.affiliation: Department of Anesthesiology, Tokyo University Branch Hospital.
authors.forename: H
authors.initials: H
authors.lastname: Fukuhara
authors.forename: T
authors.initials: T
authors.lastname: Kitamura
authors.forename: Y
authors.initials: Y
authors.lastname: Nishimura
authors.forename: T
authors.initials: T
authors.lastname: Fujimoto
authors.forename: H
authors.initials: H
authors.lastname: Tamai
authors.forename: T
authors.initials: T
authors.lastname: Umeyama
authors.forename: C
authors.initials: C
authors.lastname: Yajima
authors.forename: M
authors.initials: M
authors.lastname: Chinzei
authors.forename: M
authors.initials: M
authors.lastname: Tagami
authors.forename: K
authors.initials: K
authors.lastname: Hanaoka
mesh_terms: D000368:Aged; D000768:Anesthesia, General / Q000009:adverse effects*; D006801:Humans; D007431:Intraoperative Complications / Q000601:surgery*; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008297:Male; D011015:Pneumonia, Aspiration / Q000209:etiology*; D011468:Prostatectomy / Q000009:adverse effects*; D012086:Reoperation; D012421:Rupture; D001743:Urinary Bladder / Q000293:injuries* / Q000601:surgery