Work

Iatrogenic rupture of the left main bronchus secondary to repeated surgical lobe torsion during double-lumen tube placement

Year: 2017

Type: article

Abstract: RATIONALE: Bronchial rupture is a rare but potentially life-threatening complication during double-lumen endobronchial tube placement. The rupture of the left main bronchus resulting from repeated surgical torsion is uncommon. PATIENT CONCERNS: A 70-year-old man with a history of chronic obstructive pulmonary disease (COPD), intermediate emphysema, chronic bronchitis, hypertension, type 2 diabetes mellitus, and L3-L4 lumbar intervertebral disc herniation. Chest x-ray and computed tomography revealed a solitary pulmonary nodule in the left lower lobe. DIAGNOSES: Left lower lobe carcinoma. INTERVENTIONS: To improve surgical access, forceps were used to oppress and torque the left lung. OUTCOMES: An irregular, circular, horizontal, full-thickness rupture of 1.2 cm was observed at the tip of the bronchial tube in the left main bronchus upon examination of the bronchial stump.The rupture was repaired via primary suturing with 4-0 prolene thread and secondary reinforcement with a pericardial flap through a left thoracotomy, with no further complications. LESSONS: Caution should be exercised during compression and torsion of the pulmonary lobe when attempting to improve surgical access, especially in patients with COPD. Conversion to thoracotomy is recommended if other measures have been unsuccessful.

Source: Medicine

DOI: 10.1097/md.0000000000007694

Authors: Zong Ming Jiang, Chu Zhang, Zhong Hua Chen

Institutions: Shaoxing People's Hospital, Zhejiang University

Language: English

Topic: Airway Management and Intubation Techniques

Subfield: Anesthesiology and Pain Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,950