Open AccessIatrogenic tracheobronchial tear during paediatric thoracoscopic oesophageal repair: an anaesthetic challenge
Author(s) -
Pooja Bola Rajendra Devendra Kamath,
Handattu Mahabaleswara Krishna,
Lokvendra Singh Budania,
Anitha Nileshwar
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2018-228567
Subject(s) - medicine , surgery , intubation , iatrogenic injury , left main bronchus , tracheal tube , bronchus , thoracoscopy , catheter , bronchoscopy , anesthesia , lung , respiratory disease
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.