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Emergency cricothyroidotomy following tracheobronchial stenting
Simon Robert Cavinato1, Mike Denning2, Brendan P Madden3
1Department of Cardiothoracic Intensive Care, Saint George's Healthcare NHS Trust, London, UK.
BMJ Case Reports
|February 27, 2017
Summary
A tracheobronchial stent for esophageal cancer caused severe airway obstruction. Emergency cricothyroidotomy was successful, followed by stent removal and tracheostomy, leading to full recovery.
Area of Science:
- Respiratory Medicine
- Gastroenterology
- Oncology
Background:
- Esophageal carcinoma can cause airway compromise requiring intervention.
- Tracheobronchial stenting is a potential treatment for malignant airway obstruction.
Observation:
- A 51-year-old male with esophageal cancer developed stridor due to tumor infiltration and left vocal cord palsy.
- Post-stenting, the patient experienced severe upper airway obstruction, bilateral vocal cord palsy, and edema.
- Initial tracheostomy attempt was obstructed by the migrated stent.
Findings:
- Emergency cricothyroidotomy was successfully performed according to Difficult Airway Society (DAS) guidelines.
- The occluded stent was removed, and a tracheostomy was placed two days later.
- The patient achieved a full neurological recovery.
Implications:
- This case highlights the potential for tracheobronchial stent migration and associated airway complications.
- Prompt recognition and adherence to difficult airway management guidelines are crucial.
- Cricothyroidotomy can be a life-saving intervention in stent-related airway emergencies.
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