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The Rigid Tube as an Alternative in Controlling the Problematic Airway
Published on: June 6, 2020
A Case Report of Unanticipated Difficult Intubation Due to Posterior Tracheal Angulation
Teresa H Jiang1, Vivek Arora1,2
1University of Washington, Seattle.
Background:
Lateral tracheal deviation from mechanical compression is well-known, but anterior-posterior (A-P) deviation has been rarely reported.
Case Presentation:
A 50-year-old male with a history of chronic cerebral venous sinus thrombosis and taking enoxaparin presented to the emergency department for recurrent headaches. The patient experienced cardiac arrest and endotracheal tube (ETT) advancement was difficult secondary to unexpected posterior tracheal deviation encountered during cardiopulmonary resuscitation. Flexible fiber-optic bronchoscopy was performed to traverse the acute angulation and advance the ETT.
Conclusions:
Tracheal deviation in the A-P direction should be considered as a cause of difficult ETT advancement, and fiber-optic bronchoscopy should be performed early to diagnose such lesions.
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