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Utility of Video Laryngoscopy in Diagnosing Unanticipated Gastro-Tracheal Fistula Following Intubation for Supratentorial Craniotomy

Year: 2024

Type: article

Abstract: Gastro-tracheal fistula (GTF) is a rare but serious complication that can occur after esophagectomy. It involves an abnormal connection between the gastric conduit and the trachea that allows gastric contents to enter the respiratory tract. Although GTF is uncommon, it can lead to severe complications such as aspiration pneumonia, respiratory distress, mediastinitis, and sepsis. This case report details the management of an unexpected air leak in a 55-year-old female with a history of esophagectomy who was scheduled for an urgent supratentorial craniotomy. During anesthesia induction, a significant air leak was detected using a McGrath video laryngoscopy (VDL). This tool helped identify the leak and led to further investigation with fiberoptic bronchoscopy, which uncovered a GTF originating from the right main bronchus. The surgical procedure was postponed for a multidisciplinary assessment, and esophageal stenting was later used to manage the fistula successfully. This case highlights the crucial role of VDL in the early detection and management of complex airway issues, demonstrating its importance in enhancing patient outcomes through improved decision-making and interdisciplinary collaboration.

Source: Cureus

DOI: 10.7759/cureus.69499

Authors: Syed Muhammad Hussain Rizvi, Muhammad Irfan Ul Haq, Faraz Shafiq

Institutions: Aga Khan University, North Cumbria Integrated Care NHS Foundation Trust

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: diamond

OpenAlex ID: W4402810574