Korean J Anesthesiol.  2000 Jun;38(6):1081-1083. 10.4097/kjae.2000.38.6.1081.

Tracheal Diverticulum Discovered during Endotracheal Intubation

• Jang YH
• Lee SA
• Park GS
• Kim CS
• Kim HS

• KMID: 2155263
• DOI: http://doi.org/10.4097/kjae.2000.38.6.1081

Abstract

A seven-year-old boy with a history of recurrent aspiration pneumonia was admitted to the Seoul National University Hospital for suspension examination. Anesthesia was induced through the T-cannula with oxygen and enflurane, and ventilation of the lungs was performed easily and resulted in good bilateral breathing sounds. After administration of thiopental, atropine, and vecuronium, endotracheal intubation was administered through the tracheostomy site with an endotracheal tube. Manual ventilation through the pediatric circuit system failed to raise the chest wall. Breathing sounds were absent. Manual assessment of the reservoir bag revealed extremely poor compliance. Immediately, we examined the trachea via ventilation-assisted bronchoscopy and a 2 cm-long diverticulum located in the posterior wall 1.5 cm below the tracheostomy site was discovered. we could therefore understand the reason for the ventilation impairment. The tip of the tube impinged through the diverticulum. After widening the pathway, endotracheal intubation was accomplished successfully into the tracheostomy site and ventilation of the lung was performed easily and resulted in good bilateral breathing sounds. After suspension examination and T-cannula insertion the patient recovered from anesthesia and was transfered to the recovery room.

Keyword

Anesthesia: general; Surgery: suspension laryongoscopic examination; Ventilation: failure

MeSH Terms

Anesthesia
Atropine
Bronchoscopy
Compliance
Diverticulum*
Enflurane
Humans
Intubation, Intratracheal*
Lung
Male
Oxygen
Pneumonia, Aspiration
Recovery Room
Respiratory Sounds
Seoul
Thiopental
Thoracic Wall
Trachea
Tracheostomy
Vecuronium Bromide
Ventilation
Atropine
Enflurane
Oxygen
Thiopental
Vecuronium Bromide