Korean J Anesthesiol.  2002 Aug;43(2):255-258. 10.4097/kjae.2002.43.2.255.

Gastric Rupture after Failed Intubation for Cesarean Section

• Choi DH
• Choi HS
• Kim JA
• Choi JS

• KMID: 2236774
• DOI: http://doi.org/10.4097/kjae.2002.43.2.255

Abstract

A 27-year-old parturient in her gestational age of 38(+4) weeks was admitted to the obstetric emergency room due to fetal distress and suspected pneumoperitoneum after a failed intubation during anesthetic induction for cesarean delivery, which occurred at an obstetric clinic. On admission, she was drowsy, her abdomen was excessively distended, and the fetal heart tone was inaudible. An emergency cesarean section was performed after a standard laryngeal mask airway (size 4) was inserted for general anesthesia. At the moment the peritoneum was opened, a great amount of free air escaped. A floppy baby was delivered with an Apgar score 1 at 1 min and 4 at 5 min. Before transfer to the neonatal intensive care unit, the baby was resuscitated and intubated. Immediately after the cesarean section was completed, an emergency exploratory laparotomy was carried out. During the laparotomy, a linear tear, 8.2 cm long, along the lesser curvature of stomach was identified and repaired. The patient and her baby recovered uneventfully and were dischargedon the 7(th) postoperative day.

Keyword

Difficult airway; failed intubation; cesarean section; gastric rupture; pneumoperitoneum; laryngeal mask airway

MeSH Terms

Abdomen
Adult
Anesthesia, General
Apgar Score
Cesarean Section*
Emergencies
Emergency Service, Hospital
Female
Fetal Distress
Fetal Heart
Gestational Age
Humans
Infant, Newborn
Intensive Care, Neonatal
Intubation*
Laparotomy
Laryngeal Masks
Peritoneum
Pneumoperitoneum
Pregnancy
Stomach
Stomach Rupture*
United Nations