Right upper lobe collapse secondary to an anomalous bronchus after endotracheal intubation for routine surgery.
Perioperative hypoxaemia is a common but serious problem with well recognised causes. However, an anomalous bronchus causing lobar collapse as a cause is seldom mentioned. A healthy young male patient was anaesthetised for a knee operation. He required re-intubation immediately postoperatively for hypoxia. He was found to have right upper lobe collapse. Fibreoptic examination of the trachea demonstrated an anomalous bronchus as the cause. Intra-operatively, the endotracheal tube had been inserted too deeply and the bronchial orifice had been obstructed by the tip. It took several hours for the lung to re-expand. Greater awareness of this potential complication is needed.
Critchley
L A H
LA
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
Ho
A M H
AM
Ho
M
M
Lee
S Y
SY
D000328:Adult; D000758:Anesthesia / Q000379:methods; D016118:Anterior Cruciate Ligament / Q000601:surgery; D001182:Arthroscopy / Q000379:methods*; D001980:Bronchi / Q000002:abnormalities* / Q000503:physiopathology; D001995:Bronchography / Q000379:methods; D001999:Bronchoscopy / Q000379:methods; D003937:Diagnosis, Differential; D005336:Fiber Optic Technology / Q000379:methods; D006801:Humans; D000860:Hypoxia / Q000209:etiology* / Q000628:therapy; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008297:Male; D019300:Medical Errors / Q000009:adverse effects; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D001261:Pulmonary Atelectasis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013902:Radiography, Thoracic / Q000379:methods