Shih Chang-Chih, Wang Jen-Chun, Chen Sy-Jou, Hsu Yuan-Pin
Department of Emergency Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan.
Department of Emergency, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
J Med Ultrasound. 2019 Apr-Jun;27(2):101-103. doi: 10.4103/JMU.JMU_95_18. Epub 2019 Jan 8.
Ludwig's angina is a rapidly progressive and life-threatening medical emergency. The mortality rate is about 8%. Management of the difficult airway in Ludwig's angina has been challenging for clinical physicians. We reported an otherwise healthy 49-year-old female, who visited our emergency department with progressive swelling of her chin, drooling, and dyspnea. Ludwig's angina with impending airway compromise was promptly identified. The precise anatomy of the distorted neck was accessed using ultrasound as an adjunct. Emergent tracheostomy was then established successfully within minutes. Physicians should consider using ultrasound as an adjunct to define anatomy before performing emergent surgical airways.
路德维希咽峡炎是一种进展迅速且危及生命的医疗急症。死亡率约为8%。对临床医生而言,处理路德维希咽峡炎患者的困难气道一直具有挑战性。我们报告了一名49岁的健康女性,她因下巴逐渐肿胀、流口水和呼吸困难前来我院急诊科就诊。很快确诊为伴有即将出现气道梗阻的路德维希咽峡炎。使用超声作为辅助手段来了解颈部变形的精确解剖结构。随后在数分钟内成功实施了紧急气管切开术。在进行紧急手术气道操作前,医生应考虑使用超声作为辅助手段来明确解剖结构。