Accidental Bronchial Rupture Due to Intubation with Left-sided Double-Lumen Endotracheal Tube

使用左側雙腔導管插管意外導致支氣管破裂之病例報告

郭奇坤(Chi-Kun Kuo) ； 林信隆(Shinn-Long Lin)

《輔仁醫學期刊》 10卷1期 (2012/03) Pp. 51-57

摘要

開胸手術中因使用雙腔導管而造成支氣管破裂等嚴重併發症的報告並不多。在此我們報告一位六十歲男性，因轉移性肺腫瘤進行右側開胸術，並使用左側雙腔導管插管。於開胸後意外發現中縱膈腔氣腫，並於左側支氣管發現一撕裂傷口。立即進行支氣管修補後並未發生其他後遺症，病人亦於術後兩週順利出院。參考近年相關文獻報告後，整理可能的原因並建議利用影像學合併壓力計等方式減少類似併發症。

關鍵字

支氣管破裂 ； 雙腔導管 ； 呼吸道傷害

並列摘要

Bronchial rupture caused by intubation with a double-lumen endotracheal tube (DLT) is a rare but serious complication. We report a case of 60-year-old man with a diagnosis of metastatic lung adenocarcinoma who received general anesthesia for a right thoracotomy with a left-sided polyvinylchloride (PVC) double-lumen endobronchial tube (37Fr). Upon opening his chest wall, pneumomediastinum and a laceration wound over the left main-stem bronchus were found by the surgeon. The bronchial laceration was immediately repaired, and neither bronchial leak nor mediastinitis developed after surgery. The patient was discharged uneventfully 2 weeks later. Potential mechanisms and risk factors of DLT-induced bronchial rupture are discussed.

並列關鍵字

bronchial rupture ； double lumen tube ； airway injury