title: Unexpected intraoperative desaturation and lobar atelectasis due to left bronchial occlusion by concealed ascending aortic aneurysm.
abstract: An 81-year-old male scheduled for debridement of a perianal abscess sustained acute upper airway obstruction with atelectasis of the left lower lobe during induction of anesthesia. Results of a fiberoptic bronchoscopy revealed dorsal bulging and obstruction of the left bronchus. Under the context of tortuous aorta and calcified left border of the heart silhouette, aortic aneurysm was suspected; the diagnosis was confirmed by a computed tomography scan. Aortic aneurysm without specific symptoms cannot be screened by a single preoperative chest X-ray. The anesthesiologist should promptly request further radiographic studies to rule out potential aortic pathology if in doubt.
authors.affiliation: Department of Anesthesiology, Changhua Christian Hospital, Changhua, Taiwan. 150623@cch.org.tw
authors.forename: Jinn-Sheng
authors.initials: JS
authors.lastname: Huang
authors.forename: Chia-Hsiang
authors.initials: CH
authors.lastname: Huang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta; D001014:Aortic Aneurysm / Q000150:complications*; D001982:Bronchial Diseases / Q000150:complications*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D008297:Male; D010100:Oxygen / Q000097:blood*; D001261:Pulmonary Atelectasis / Q000209:etiology*
chemical_list: D010100:Oxygen