Unexpected blood clot-induced acute airway obstruction in a patient with inactive pulmonary tuberculosis during lumbar spine surgery in the prone position--a case report.
Airway obstruction is always a life-threatening event, and it must be recognized and managed immediately. We report an instance of acute airway obstruction associated with hemoptysis in an elderly patient with inactive advanced pulmonary tuberculosis (TB) while undergoing spine surgery. Airway obstruction was highly suspected in consequence of postural change because immediate resolution was rewarded after reversion of the position from prone to supine. The chest surgeon consulted intraoperatively did a fiberoptic bronchoscopy and found that the blood was mainly surging from the branching bronchus of right lower lobe, and thus the source of bleeding was confirmed. Hence, in this presentation we discuss the contributory factors which led to the occurrence of hemoptysis and the appropriate perioperative management of this kind of airway obstruction.
Lin
Jui-An
JA
Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, ROC.
Wong
Chih-Shung
CS
Cherng
Chen-Hwan
CH
D000208:Acute Disease; D000368:Aged; D000402:Airway Obstruction / Q000209:etiology* / Q000628:therapy; D006469:Hemoptysis / Q000150:complications*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D007442:Intubation, Intratracheal; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D016684:Prone Position; D014397:Tuberculosis, Pulmonary / Q000150:complications*