title: Fatal visit to the dentist.
abstract: A 23-year-old woman was mortally afraid of dental interventions and decided to have her four wisdom teeth removed by outpatient surgery under endotracheal anaesthesia. According to the files, the patient was categorized as ASA I and Mallampati II, and surgery was considered an elective routine intervention. Soon after initiation of anaesthesia, O2 saturation and blood pressure dropped, and the young woman died shortly afterwards in spite of immediate resuscitation measures. At first, an allergic reaction to succinylcholine, which had been administered as a muscle relaxant, was suspected. Autopsy and histological examination showed haemorrhagic pulmonary oedema and a defined lesion in the midportion of the oesophageal mucosa in spite of correct placement of the endotracheal breathing tube. Ultimately, misintubation into the oesophagus, which had not been noticed at first, was determined as cause of death.
authors.affiliation: Institut für Rechtsmedizin, Julius-Maximilians-Universität, Versbacher Str. 3, 97078, Würzburg, Germany, vera.sterzik@uni-wuerzburg.de.
authors.forename: Vera
authors.initials: V
authors.lastname: Sterzik
authors.forename: Thomas
authors.initials: T
authors.lastname: Tatschner
authors.forename: Norbert
authors.initials: N
authors.lastname: Roewer
authors.forename: Daniel
authors.initials: D
authors.lastname: Barrera
authors.forename: Michael
authors.initials: M
authors.lastname: Bohnert
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects*; D004947:Esophagus / Q000293:injuries* / Q000473:pathology; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000473:pathology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D009092:Mucous Membrane / Q000293:injuries* / Q000473:pathology; D011654:Pulmonary Edema / Q000209:etiology / Q000473:pathology; D014081:Tooth Extraction; D055815:Young Adult