Farkas Gabriel, Lederman Debra, Pradhan Tana, Harris Kassem
Department of Anesthesiology, Interventional Pulmonology Section, New York Medical College, Westchester Medical Center, Valhalla, NY, USA.
Department of Gynecology, Interventional Pulmonology Section, New York Medical College, Westchester Medical Center, Valhalla, NY, USA.
J Thorac Dis. 2018 May;10(5):3098-3101. doi: 10.21037/jtd.2018.03.118.
Foreign body aspiration during medical procedures has been reported in the literature. These iatrogenic incidents could be related to instruments malfunction or to accidental occurrences during medical treatment. In this paper, we present a report of a woman coming for a laparoscopic abdominal hysterectomy who developed intraoperative bronchospasm. In an attempt to administer aerosolized albuterol, the resident anesthesia provider fractured the Luer-lock tip of the 60-cc syringe, which he was using to hold the albuterol nebulizer. The plastic tip was dislodged into the endotracheal tube (ETT). On further inspection with a fiberoptic instrument the plastic tip was located loosely adherent to the distal part of the ETT and was held in place by the moisture, which had precipitated in the distal tube. An intraoperative consult with interventional pulmonary medicine was obtained after unsuccessfully attempting to retrieve the foreign body with a grasper. The syringe tip was then removed using a Fogarty balloon catheter that was threaded through the hole of the plastic tip.
医学文献中已报道过医疗操作过程中的异物吸入情况。这些医源性事件可能与器械故障或治疗过程中的意外情况有关。在本文中,我们报告了一名接受腹腔镜腹部子宫切除术的女性,术中出现支气管痉挛。在试图给予雾化沙丁胺醇时,住院麻醉医生将用于固定沙丁胺醇雾化器的60毫升注射器的鲁尔锁尖端弄断了。塑料尖端掉入气管内导管(ETT)中。通过纤维光学器械进一步检查发现,塑料尖端松散地附着在ETT的远端,被远端导管中凝结的水分固定在那里。在用抓取器试图取出异物未成功后,术中咨询了介入肺科医生。然后使用一根通过塑料尖端的孔穿入的Fogarty球囊导管取出了注射器尖端。