Xiong Jun, Zhou Quan, Li Yu, Sun Yanyan, Zhang Yajun
Department of Anesthesiology, Shenzhen University General Hospital, Shenzhen University, Shenzhen, China.
Department of Radiology, Jiangsu Province Hospital of Integration of Chinese and Western Medicine, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China.
Front Surg. 2022 Aug 23;9:961186. doi: 10.3389/fsurg.2022.961186. eCollection 2022.
Tracheobronchomegaly (TBM) is a rare disease with enlarged trachea and mainstem bronchi, which might not be diagnosed preoperatively because of patient's nonsymptoms or clinicians' overlook. These patients would be at fatal risk after general anesthesia endotracheal intubation due to severe peritubal leakage. This case may provide a helpful and informative resource for anesthesiologists and other clinicians, especially those managing patients' airways.
We presented a patient undergoing elective scoliosis orthopedics who was postoperatively diagnosed with TBM. After general anesthesia endotracheal intubation, difficulty in maintaining ventilation with obvious peri-cuff air leakage made this rare disease to be suspected. The peritubal leakage was resolved by relocating the endotracheal tube to the subglottic area. Fortunately, there were no air leakage and postoperative complications.
Anesthesiologists should keep the possibility of the unpredicted anatomic abnormal respiratory tract in mind, such as TBM.
气管支气管巨大症（TBM）是一种罕见疾病，其气管和主支气管会扩大，由于患者无症状或临床医生忽视，术前可能无法诊断。这些患者在全身麻醉气管插管后因严重的气管周围漏气而面临致命风险。该病例可为麻醉医生和其他临床医生，尤其是那些处理患者气道的医生提供有用且信息丰富的参考资料。
我们报告了一名接受择期脊柱侧弯矫形手术的患者，术后被诊断为气管支气管巨大症。全身麻醉气管插管后，维持通气困难且有明显的气囊周围漏气，这使得这种罕见疾病受到怀疑。将气管导管重新放置到声门下区域后，气管周围漏气得到解决。幸运的是，没有漏气情况和术后并发症。
麻醉医生应牢记存在不可预测的解剖学异常呼吸道的可能性，如气管支气管巨大症。
