Suspected pharyngoesophageal perforation after a difficult intubation: a case report.
Although uncommon and rarely reported, pharyngoesophageal perforation has medical and legal consequences of substantial proportion. Perforation of the upper aerodigestive system may result in severe airway complications that include pneumothorax, pneumonia, mediastinitis, and retropharyngeal abscess. Despite the relative rare occurrence of esophageal perforation during intubation, this type of injury is associated with the poorest outcome, especially when the diagnosis and treatment are delayed. Our case report presents a healthy 23-year-old female for a thyroidectomy. Postoperatively she developed what appeared to be symptoms of pharyngoesophageal injury, suspected to be related to blunt trauma from laryngoscopy. Knowledge of and prompt attention to the cardinal signs of pharyngoesophageal injury in partnership between the anesthetist and the surgical team were the key instruments in ruling out this potentially devastating diagnosis.
Heater
Douglas Winston
DW
Nurse Anesthesia Program, Georgetown University, School of Nursing and Health Studies, Washington, DC, USA.
Haskvitz
Leah
L
D000328:Adult; D003680:Deglutition Disorders / Q000209:etiology; D004939:Esophageal Perforation / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007828:Laryngoscopy / Q000009:adverse effects*; D008478:Mediastinal Emphysema / Q000209:etiology; D019547:Neck Pain / Q000209:etiology; D010614:Pharynx / Q000293:injuries*; D012307:Risk Factors; D013352:Subcutaneous Emphysema / Q000209:etiology; D016606:Thyroid Nodule / Q000601:surgery; D013965:Thyroidectomy; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000209:etiology*; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000209:etiology*