Subcutaneous emphysema and pneumomediastinum after translaryngeal intubation: tracheal perforation due to unsuccessful fiberoptic tracheal intubation.
A 77-year-old man was scheduled to undergo a cervical lymph node biopsy under general anesthesia. Although awake, nasotracheal fiberoptic intubation was initially planned because of an anticipated difficult airway, the attempt was unsuccessful. Orotracheal intubation was subsequently performed under direct laryngoscopy without difficulty. After initiating positive pressure mechanical ventilation, subcutaneous and mediastinal emphysema developed. The cause of this emphysema was considered to be tracheal perforation after an unsuccessful attempt at fiberoptic tracheal intubation.
Department of Anesthesiology and Critical Care Medicine, Tokyo Medical and Dental University, Tokyo 1138519, Japan.
Yuko
Y
Kaneko
Koichi
K
Nakazawa
Kazuaki
K
Yokoyama
Seiji
S
Ishikawa
Tokujiro
T
Uchida
Masatoki
M
Takahashi
Atsunobu
A
Tsunoda
Koshi
K
Makita
D000368:Aged; D000768:Anesthesia, General; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007828:Laryngoscopy; D007830:Larynx / Q000293:injuries*; D016393:Lymphoma, B-Cell / Q000473:pathology; D008297:Male; D008478:Mediastinal Emphysema / Q000209:etiology* / Q000503:physiopathology; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D012121:Respiration, Artificial; D021701:Sentinel Lymph Node Biopsy; D013352:Subcutaneous Emphysema / Q000209:etiology* / Q000503:physiopathology; D014132:Trachea / Q000293:injuries*