Thoracic Surgery Unit, Tawam Hospital, Al-Ain, PO Box 15258, United Arab Emirates.
Singapore Med J. 2011 May;52(5):e96-9.
We report two rare cases of tracheobronchial injury (TBI) following endotracheal intubation. Both intubations were easy and performed by experienced anaesthetists. The injuries for both cases were possibly caused by the tip of an endotracheal tube. A 27-year-old woman regurgitated copiously during induction of general anaesthesia for a Caesarean section. She had a full-thickness TBI 2 cm above the carina, which was repaired through an open thoracotomy. A 68-year-old woman undergoing left mastectomy was intubated with a 7.5-mm endotracheal tube for general anaesthesia. 24 hours after extubation, the patient developed widespread subcutaneous emphysema. There was no associated respiratory distress, and the patient was treated conservatively. The fragile tracheal tissue associated with pregnancy and old age was possibly a contributing factor for injury. Both patients recovered well. Surgical and non-surgical methods can be safely used after careful consideration of the patient's clinical, radiological and endoscopic findings.
我们报告了两例罕见的气管支气管损伤(TBI),均发生于气管插管后。两次插管均由经验丰富的麻醉师完成,操作简单。两例损伤可能均由气管导管尖端引起。一例 27 岁女性在剖宫产全身麻醉诱导期间大量呕吐,隆突上方 2 厘米处发生全层 TBI,通过开胸手术修复。另一例 68 岁女性在全身麻醉下使用 7.5mm 气管导管行左乳房切除术。拔管后 24 小时,患者出现广泛皮下气肿。无相关呼吸窘迫,患者予保守治疗。妊娠和老年相关的脆弱气管组织可能是损伤的一个促成因素。两名患者均恢复良好。在仔细考虑患者的临床、影像学和内镜检查结果后,可以安全地使用手术和非手术方法。