Iatrogenic tracheobronchial tear during paediatric thoracoscopic oesophageal repair

An anaesthetic challenge

Pooja Bola Rajendra Devendra Kamath, Handattu Mahabaleswara Krishna, Lokvendra Budania, Anitha Nileshwar

Research output: Contribution to journalArticle

Abstract

Iatrogenic tracheobronchial injury is rare. Limited data is available on such injuries in infants and management of these is challenging. We present a 7-month-old male infant who was diagnosed with oesophageal stricture, and was planned for thoracoscopic repair of the same. Anaesthetic management with a single lumen tracheal tube ensued. However, an intraoperative loss of capnogram and desaturation led to the diagnosis of iatrogenic tracheobronchial injury. After unsuccessful pursuits with a Fogarty catheter through the tracheobronchial tear and through the right bronchus for lung isolation, blind left endobronchial intubation with a smaller tube and one lung ventilation was successful. The rent was repaired by an open procedure, and oesophageal surgery completed. However, the child succumbed and died of multiorgan failure 3 days later.

Original languageEnglish
Article numbere228567
JournalBMJ Case Reports
Volume12
Issue number5
DOIs
Publication statusPublished - 01-05-2019

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Tears
Anesthetics
Pediatrics
Wounds and Injuries
One-Lung Ventilation
Esophageal Stenosis
Bronchi
Intubation
Catheters
Lung

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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abstract = "Iatrogenic tracheobronchial injury is rare. Limited data is available on such injuries in infants and management of these is challenging. We present a 7-month-old male infant who was diagnosed with oesophageal stricture, and was planned for thoracoscopic repair of the same. Anaesthetic management with a single lumen tracheal tube ensued. However, an intraoperative loss of capnogram and desaturation led to the diagnosis of iatrogenic tracheobronchial injury. After unsuccessful pursuits with a Fogarty catheter through the tracheobronchial tear and through the right bronchus for lung isolation, blind left endobronchial intubation with a smaller tube and one lung ventilation was successful. The rent was repaired by an open procedure, and oesophageal surgery completed. However, the child succumbed and died of multiorgan failure 3 days later.",
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Iatrogenic tracheobronchial tear during paediatric thoracoscopic oesophageal repair : An anaesthetic challenge. / Kamath, Pooja Bola Rajendra Devendra; Krishna, Handattu Mahabaleswara; Budania, Lokvendra; Nileshwar, Anitha.

In: BMJ Case Reports, Vol. 12, No. 5, e228567, 01.05.2019.

Research output: Contribution to journalArticle

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