Open AccessAirway and Anaesthetic Challenges in a Child With Bronchus Suis and Superimposed Double Aortic Arch
Author(s) -
Nigel Kuriakose,
Mohamed Al-Ismaili,
Sameer Raniga,
Rohit Date,
Ali Al-Abady,
Zainab Al-Balushi
Publication year - 2021
Publication title -
sultan qaboos university medical journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.258
H-Index - 27
eISSN - 2075-0528
pISSN - 2075-051X
DOI - 10.18295/squmj.2021.21.01.020
Subject(s) - medicine , bronchus , aortic arch , airway , respiratory distress , double aortic arch , bronchoscopy , lobar pneumonia , vascular ring , right main bronchus , surgery , lumen (anatomy) , pneumonia , anesthesia , aorta , respiratory disease , lung
Bronchus suis or tracheal bronchus is an accessory bronchus arising from the trachea above the carina. Double aortic arch is a congenital vascular anomaly with persistence of both left and right aortic arches beyond fetal life which can form a vascular ring compressing the major airways and may be symptomatic. We report the case of a 16-month-old girl who had recurrent episodes of respiratory distress requiring multiple hospitalisations and was diagnosed at the Sultan Qaboos University Hospital, Muscat, Oman in 2019 with a double aortic arch compressing upon a tracheal bronchus causing symptomatic emphysema of the right upper lobe. This report presents anaesthetic and airway challenges during the patient's lobectomy. A single lumen cuffed endotracheal tube was successfully used as a bronchial blocker to occlude the origin of the aberrant bronchus. The position of the tube was confirmed intraoperatively using fibreoptic bronchoscopy. Following her discharge, she continued to have recurrent episodes of respiratory distress and three months after her last appointment she succumbed to her illness. To the best of the authors' knowledge, this is the first such reported case in Oman.