1/19. Anaesthetic management of a patient with low tracheal obstruction requiring placement of a T-Y stent.A 60-year-old man with a history of oesophagectomy for carcinoma presented with worsening dysphagia, dyspnoea and tachypnoea secondary to oesophageal stricture and tumour invasion of the trachea causing a "ball-valve" obstruction. The patient required placement of a T-Y tracheobronchial stent to relieve the airway obstruction and was successfully managed using sevoflurane for gaseous induction followed by maintenance with propofol total intravenous anaesthesia.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/19. General anaesthesia in a patient with undiagnosed "saber-sheath" trachea.Saber-sheath trachea describes an abnormality in the shape of the trachea caused by underlying disease processes. We present a case of tracheal stenosis in a patient with undiagnosed saber-sheath trachea, in which there was unexpected difficulty in ventilating the lungs despite a good view at laryngoscopy and visually confirmed tracheal intubation.- - - - - - - - - - ranking = 4keywords = anaesthesia (Clic here for more details about this article) |
3/19. Unsuspected concentric tracheal rings in a 14-year-old with scoliosis.A 14-yr-old boy was first found to have tracheal stenosis when anaesthesia was induced for extensive scoliosis surgery in the prone position. There are no guidelines for airway management under these conditions. We describe how we managed the problem and suggest some useful modifications.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
4/19. Polyflex stent: is it radiopaque enough?We report a case of tracheal stenosis in which a migrated Polyflex (Rusch AG, germany) stent entered the right main bronchus but could not be identified on the chest radiograph. The stent was identified at bronchoscopy and removed under general anaesthesia. Polyflex stents are radiopaque but may not always show up on radiograph. We recommend reliance on clinical symptoms rather than imaging to diagnose migration. If stent migration is suspected then imaging should include thoracic inlet films that incorporate a lateral view.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
5/19. Temporary cardiopulmonary bypass and isolated lung ventilation for tracheal stenosis and reconstruction.A 27-yr-old lady with a past history of prolonged ventilation presented with worsening respiratory distress caused by tracheal stenosis. She required urgent tracheal resection and reconstruction. Because of the risk of an acute respiratory obstruction, spinal anaesthesia was used to establish cardiopulmonary bypass by cannulating the femoral artery and femoral vein. Adequate gas exchange was possible with full flow rate. thoracotomy was then carried out to mobilize the left main bronchus. After successfully securing an airway by intubation of the left main bronchus, cardiopulmonary bypass was discontinued and tracheal resection and anastomosis was done under conventional one lung anaesthesia.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |
6/19. Preoperative airway evaluation using multi-slice three-dimensional computed tomography for a patient with severe tracheal stenosis.A 71-yr-old female with a malignant thyroid tumour was to undergo thyroidectomy under general anaesthesia. Preoperative chest x-ray and plain computed tomography (CT) showed severe tracheal stenosis. Three-dimensional figures of the trachea and a virtual bronchoscopic movie were obtained from multi-slice CT to evaluate the stenotic region and to simulate fibroscopic tracheal intubation, respectively. After induction of general anaesthesia with propofol, a tracheal tube was successfully passed through the stenotic region under the guide of a fibroscope as simulated in the virtual movie. We conclude that multi-slice CT is useful for preoperative airway evaluation for patients with stenosis and distortion of the trachea.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |
7/19. magnetic resonance imaging as a new diagnostic criterion in paediatric airway obstruction.magnetic resonance imaging of the trachea was performed in 21 children with congenital or acquired narrowing of the trachea or main bronchi. Diagnosis included aortic arch anomalies, innominate artery compression, pulmonary artery compression and tracheomalacia. All patients were examined after bronchoscopy. The demonstration of the trachea and the surrounding tissue and vessels on MR images enables the cause of tracheal compression and the degree and location of collapse to be evaluated. MRI is a modality well suited to characterizing tracheal narrowing without employing ionizing radiation or intravenous contrast medium. All MRI examinations were carried out with the patient under general anaesthesia so as not to risk pulmonary deterioration during sedation. In the cases presented MRI is the diagnostic step of choice after tracheobronchoscopy and broadens the diagnostic potential in extrinsic tracheal or bronchial stenosis in paediatric patients.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
8/19. Resection for congenital tracheal stenosis.A case of congenital tracheal stenosis is reported. The diagnosis was made on plain X-ray, tomography and computerized axial tomography of the trachea when the child was 8 years old. The operative approach was via a median sternotomy and anaesthesia maintained with dual simultaneous ventilation of the right upper lobe bronchus and distal trachea. histology of the stenotic area revealed the cartilaginous rings to be completely encircling the trachea.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
9/19. Serious sequelae of delayed diagnosis of endobronchial tuberculosis.We report three cases of pulmonary tuberculosis in whom the diagnosis of the endobronchial component was missed initially. Despite proper chemotherapy, one patient had bronchostenosis leading to acute respiratory failure and death, the second developed collapse of the left lung, while failure of endotracheal intubation for general anaesthesia was the immediate problem faced by the third patient.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
10/19. life threatening complication of high-frequency jet ventilation.high-frequency jet ventilation is being increasingly used as an alternative to conventional methods of ventilation in both anaesthesia and intensive care. We report a case of severe respiratory obstruction as a complication of high-frequency jet ventilation. patients with bleeding diathesis, including patients on haemodialysis, may particularly be at risk.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
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