title: Foreign body removal with repair of iatrogenic tracheo-bronchial tear repair: An anesthetic challenge.
abstract: Foreign body aspiration into the airway is common in the pediatric age group and its anesthetic management is a challenge. Iatrogenic tracheo-bronchial injury further worsens the situation. Flexible pediatric fiberscope is the gold standard for securing the airway in cases of airway injury. We present a case of a 7-year-old girl who presented to the hospital with signs and symptoms of foreign body aspiration and suspected tracheo-bronchial tree injury. The impacted foreign body was removed by rigid bronchoscopy and the presence of a tracheo-bronchial tear was confirmed. To repair the airway tear, thoracotomy was planned necessitating one lung ventilation. A pediatric flexible fiberscope was not available, so left endobronchial intubation for one lung ventilation was done with the help of an airway exchange catheter using a rigid bronchoscope as a conduit. Subsequent intra-operative and post-operative period were uneventful.
authors.affiliation: Department of Anaesthesia, Maulana Azad Medical College, Delhi, India.
authors.forename: Vikram Uday
authors.initials: VU
authors.lastname: Lahori
authors.forename: Shipra
authors.initials: S
authors.lastname: Aggarwal
authors.forename: Pemala
authors.initials: P
authors.lastname: Simick
authors.forename: Sudhindra
authors.initials: S
authors.lastname: Dharmavaram
references.citation: Paediatr Anaesth. 2001 Nov;11(6):733-6
references.pmid: 11696153
references.citation: Arch Otolaryngol Head Neck Surg. 2001 May;127(5):505-9
references.pmid: 11346424
references.citation: Can J Anaesth. 1996 Feb;43(2):148-59
references.pmid: 8825540
references.citation: Acta Chir Belg. 2004 Apr;104(2):204-8
references.pmid: 15154580
references.citation: Anesth Analg. 2009 Oct;109(4):1079-84
references.pmid: 19762735
references.citation: Br J Anaesth. 1996 Jun;76(6):767-71
references.pmid: 8679346
references.citation: J Ayub Med Coll Abbottabad. 2007 Apr-Jun;19(2):46-8
references.pmid: 18183719
references.citation: Anesth Analg. 1999 Dec;89(6):1426-9
references.pmid: 10589621