Mediastinitis and sepsis syndrome following intubation

A patient developed sepsis syndrome with shock 7 h after an anaesthetic for a shoulder replacement. Tracheal intubation had been difficult and required the use of a stylet and gum-elastic bougies. A gastrografin swallow subsequently demonstrated an oesophageal perforation and mediastinitis was diagnosed at surgical exploration. She survived after a prolonged period of intensive care treatment.