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Anesthetic Experience of a Patient with Palpable Paratracheal Air Cysts in the Anterior Neck - A Case Report

경희의학 2019년 34권 1호 p.81 ~ 88
이민규 ( Lee Min-Kyu ) - Hanyang University Hospital Department of Anesthesiology and Pain Medicine

성정민 ( Sung Jeong-Min ) - Hanyang University Hospital Department of Anesthesiology and Pain Medicine
장지희 ( Chang Ji-Hee ) - Hanyang University Hospital Department of Anesthesiology and Pain Medicine
 ( Jeong Mi-Ae ) - Hanyang University Hospital Department of Anesthesiology and Pain Medicine

Abstract


Paratracheal air cysts (PACs) are clinical entities characterized by an outpouching of the trachea that can be encountered incidentally in the operating room. Most PACs are asymptomatic, but complications, such as difficult ventilation after intubation, difficulty in lung isolation, and tracheal rupture related to PACs, have been reported. Here, we report a case of a 63-year-old female whose large PACs were palpated at the anterolateral surface of the lower neck and who was at high risk of pulmonary aspiration during general anesthesia induction. We could not apply cricoid pressure due to the potential risk of PAC rupture. This situation resulted in pulmonary aspiration of gastric juices despite other supplementary preventive managements. Fortunately, the aspiration was minimal, and there were no post-operative sequelae. The authors suggest special attention should be paid to patients with PACs during general anesthesia.

키워드

Respiratory aspiration; Hiatal hernia; Paratracheal air cysts
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