[A case report of bronchial rupture with a polyvinylchloride (PVC) double-lumen tube]

The patient is a 58-year-old man with a 3-months history of painful swallowing. Endoscopy and biopsy demonstrated squamous cell carcinoma of the middle one third of the esophagus. On Sept. 13, 1987, the patient underwent surgery. The patient was intubated with the PVC double-lumen tube. After the resection of esophagus, when lymphadenectomy was performed, we noticed the herniation of a bronchial cuff through the left main bronchial tear. Surgical repair of the lesion was accomplished with a continuous suture with 3-0 vicryl. Subsequent course of the patient was uneventful. Tracheobronchial rupture is rare complication of intubation with PVC double-lumen tube. This complication results from measures such as using an inadequate tube size, malpositioning the tip of the tube, or insufflating the balloon too rapidly, which dose not allow adaptation of the balloon to the tracheobronchial wall. In our case, overinflation of the bronchial balloon was probably the etiology of rupture. This was probably secondary to diffusion of nitrous oxide, rather than initial over-distension. Meticulous cares must be emphasized to avoid such complication.