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An unexpectedly difficult intubation following repeated endoscopy.
1Department of Anaesthesia, St Helier Hospital, Carshalton, Surrey, United Kingdom.
Anaesthesia and Intensive Care
|June 17, 2005
Summary
Difficult tracheal intubation occurred in a patient with a bleeding gastric ulcer after repeated endoscopies. Management involved challenging fiberoptic intubation due to airway swelling and anatomy.
Area of Science:
- Gastroenterology
- Anesthesiology
- Airway Management
Background:
- A 67-year-old male presented with a bleeding gastric ulcer necessitating urgent laparotomy.
- The patient had undergone three upper gastrointestinal endoscopies within a five-day period prior to the surgical procedure.
Observation:
- Unexpected difficulty was encountered during tracheal intubation.
- Causes included significant supraglottic edema and unfavorable upper airway anatomy.
Findings:
- Fiberoptic intubation through a laryngeal mask airway was ultimately successful, albeit with difficulty.
- This case highlights the challenges of difficult intubation in the context of repeated endoscopic procedures.
Implications:
- Repeated upper gastrointestinal endoscopies can lead to airway complications such as supraglottic edema.
- Anesthesiologists must be prepared for difficult airway management in patients with recent endoscopic interventions.
- Careful preoperative airway assessment is crucial in patients with a history of upper gastrointestinal procedures.