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[Atelectasis after induction of general anesthesia in an infant with cleft palate]

Shiho Shibata1, Matsunaga Matsuko, Kazuo Higa

  • 1Department of Anesthesiology, Fukuoka University School of Medicine, Fukuoka 814-0180.

Masui. the Japanese Journal of Anesthesiology
|June 2, 2011
PubMed

Insights

An infant with a cleft palate aspirated milk residue during anesthesia, causing complete lung atelectasis. This case highlights the risk of aspiration in pediatric patients with cleft palate.

Area of Science:

  • Pediatric Anesthesiology
  • Otolaryngology
  • Medical Microbiology

Background:

  • Cleft palate is a congenital condition that can affect feeding and airway management in infants.
  • General anesthesia in pediatric patients requires careful consideration of airway anatomy and potential complications.

Observation:

  • A 12-month-old infant with cleft palate developed left lung atelectasis immediately after tracheal intubation for palatoplasty.
  • Breath sounds were absent on the left side, and chest X-ray confirmed complete atelectasis.

Findings:

  • Bronchoscopy revealed the left primary bronchus was obstructed by a white substance.
  • Pathological examination identified the obstruction as milk residue containing Candida species.
  • Aspiration of accumulated milk residue from the cleft palate during anesthesia induction was the suspected cause.

Implications:

  • This case underscores the critical importance of thorough preoperative assessment and meticulous airway management in infants with cleft palate.
  • It highlights the potential for aspiration of oral contents, even after fasting, in this patient population.
  • Early recognition and intervention are crucial for managing post-anesthetic respiratory complications like atelectasis.

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