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Updated: Jun 19, 2025

Author Spotlight: Point-of-Care Ultrasound for Gastric Content Assessment and Risk Stratification in Perioperative Care
Published on: September 22, 2023
Gastric distension and atelectasis after using a supraglottic airway - A case report
Yundo Jung1, Sungyeon Jung1, Seungcheol Yu1
1Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea.
Background:
Supraglottic airways (SGAs) are used during general anesthesia (GA) due to comfort. Certain complications are possible, such as gastric distension. The incidence of pulmonary aspiration of regurgitated gastric contents was found to be 0.02%. A difference in the incidence of gastric regurgitation was not identified between the use of SGAs and endotracheal intubation. We report a case of gastric distension and atelectasis in a patient in whom an I-gel® was used for GA.
Case:
A 63-year-old female patient underwent triple arthrodesis on her ankle under GA using an SGA (I-gel® size 3). After surgery, she suffered from nausea and abdominal bloating. A chest radiograph revealed that a large amount of air in her stomach had caused gastric distention, which resulted in left hemidiaphragm elevation and atelectasis.
Conclusions:
This case illustrates that the use of I-gel® in prolonged surgeries may result in malposition of the SGA and gastric insufflation and atelectasis.
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