1/267. anesthesia for insertion of a Dumon stent in a patient with a large tracheo-esophageal fistula.PURPOSE: To present the anesthetic management for the insertion of a Dumon silicon stent to the trachea of a patient with a large tracheo-esophageal fistula. The aim of the stent insertion was to seal the fistula in order to prevent aspiration of esophageal content and subsequent pneumonitis. CLINICAL FEATURES: A 45-yr-old man with a large tracheo-esophageal fistula was scheduled for the insertion of the Dumon stent. Since placement of the stent necessitates the insertion of a rigid bronchoscope, under general anesthesia, with its tip just proximal to the fistula, controlled ventilation was expected to be difficult to achieve because of the diversion of oxygen through the large fistula to the esophagus. We successfully ventilated the lungs, after the fistula was sealed using a large balloon which was inserted in the esophagus, and the stent insertion was completed uneventfully. CONCLUSION: anesthesia for procedures involving the central airway is challenging. This report describes a simple and practical method to facilitate ventilation by temporary seal of a tracheo-esophageal fistula using a modified esophageal balloon.- - - - - - - - - - ranking = 1keywords = aspiration, content (Clic here for more details about this article) |
2/267. Aspiration: a possible severe complication in colonoscopy preparation of elderly people by orthograde intestine lavage.Total gut lavage is a widely recommended method in preparation for colonoscopy and there are almost no reports of severe complications in the literature. Application of orthograde lavage by a nasogastric tube may be necessary in disorientated patients, assisted by slight medical sedation, if necessary. Despite absolutely correct appliance of the method, a case of severe aspiration with subsequent hypoxemia and stroke in a senile female patient, suffering from a common hiatal hernia, is described.- - - - - - - - - - ranking = 0.99782427865765keywords = aspiration (Clic here for more details about this article) |
3/267. Bronchoaspiration as a possible cause in a case of tetanus. A reminder on the importance of adulthood immunizations.Although preventable by immunization tetanus still takes a large death toll, mostly in developing countries, where adult population is often unprotected and opportune medical care unavailable. We present a case of tetanus in an elderly patient with bronchoaspiration pneumonia after a near-drowning incident, in which no objective entry site could be suspected with as much temporal relation as the bronchoaspiration incident. Bronchoaspiration of organic matter and feces provides both a source of the causative agent and an adequate polymicrobial environment for the development of the disease. It is under such conditions that we propose this unusual entry site as the cause of tetanus in our patient. Special emphasis is made on the importance of adulthood immunization programs and how incidents like this one should be taken into account in the overall care provided to the elderly population.- - - - - - - - - - ranking = 6.9847699506036keywords = aspiration (Clic here for more details about this article) |
4/267. Severe aspiration pneumonia after surgery for reconstructed gastric tube cancer treated with extracorporeal life support.A 68-year-old man who had received resection for thoracic esophageal cancer 8 years ago, was operated on for the cancer of the reconstructed gastric tube. On the day of the operation, he accidentally swallowed gastric juice due to an obstruction in the reconstructed gastric tube. He suffered from acute hypoxic respiratory failure which could not be controlled with conventional therapy on postoperative day 1. Therefore, extracorporeal life support was employed at 3.0 L/min. extracorporeal flow for 11 days. Before extracorporeal life support data: PO2/FiO2 = 45, A-aDO2 = 600. During extracorporeal life support, the ventilator setting was pressure control (16 cmH2O) ventilation with a positive end expiratory pressure of 8 cmH2O, respiratory rate of 5 breaths/min., and FiO2 of 0.4. The patient was successfully weaned from extracorporeal life support and extubated on postoperative day 12. After extracorporeal life support data: PO2/FiO2 = 225, A-aDO2 = 465. We report on a successful weaning case from extracorporeal life support and discuss the efficacy these of regarding this patient.- - - - - - - - - - ranking = 3.9912971146306keywords = aspiration (Clic here for more details about this article) |
5/267. Video-assisted thoracoscopic esophagomyotomy for achalasia after pulmonary lobectomy.A 52-year-old man developed achalasia and a lung abscess due to aspiration pneumonia. We conducted a right upper lobectomy by thoracotomy for the abscess and, 2 weeks later, video-assisted thoracoscopic myotomy and fundoplication (modified Belsey Mark IV procedure) though the left thorax for achalasia. Three months after surgery, the patient was free of dysphasia and chest pain and had regained his original weight. Esophageal myotomy and fundoplication using video-assisted thoracoscopy appear to be feasible in treating achalasia involving impaired pulmonary function.- - - - - - - - - - ranking = 0.99782427865765keywords = aspiration (Clic here for more details about this article) |
6/267. A method for bronchoscopic evaluation of salivary aspiration in a disabled child.Chronic aspiration is a cause of life-threatening respiratory complications and repeated hospital admissions, particularly in children with neurological disabilities. Determining the source of aspiration is important for optimizing treatment. This report describes a simple technique to demonstrate salivary aspiration during fibreoptic bronchoscopy. A child with a history of recurrent pneumonia was given methylene blue orally 2 h prior to fibreoptic bronchoscopy. bronchoscopy was carried out through a laryngeal mask airway under inhalational anaesthesia. The stained saliva was seen to be pooling in the valleculae and then running down the trachea into the bronchi, confirming salivary aspiration.- - - - - - - - - - ranking = 7.9825942292612keywords = aspiration (Clic here for more details about this article) |
7/267. A skin lesion found by serendipity.A 77-year-old retired postal worker presented with symptoms of recurrent aspiration pneumonia, for which he had last been seen one month earlier. Oropharyngeal dysfunction, presumably caused by previous strokes, was demonstrated by video-esophagoscopy, and a percutaneous gastrostomy tube was placed at that time.- - - - - - - - - - ranking = 0.99782427865765keywords = aspiration (Clic here for more details about this article) |
8/267. Fatal aspiration of sardine fry in a patient with lung cancer.We report a fatal case of death due to unusual aspiration of sardine fry in an elderly Japanese man with lung cancer. The cause of death was sudden respiratory arrest while eating. autopsy revealed peculiar materials with cell nests and pigmented particles, together with striated muscle and skin, in the ectatic bronchioles of the left lower lobe. Serial histologic sections suggested that the structures observed were the eyeballs of small animals that appeared to have been inhaled. The patient had habitually eaten sardine fry and rice gruel, which were also detected in the gastric contents. Therefore, the eyes were considered to be those of the fry, which is a popular food item in japan. This was confirmed by histologic examination of fry that were obtained commercially.- - - - - - - - - - ranking = 25.253608870738keywords = gastric content, aspiration, content (Clic here for more details about this article) |
9/267. technetium tin colloid test detecting symptomless dysphagia and ACE inhibitor prevented occurrence of aspiration pneumonia.Symptomless dysphagia and swallowing disorders play a very important role in the pathogenesis of aspiration pneumonia. A videofluoroscopic examination and a simple two-step swallowing provocation test (STS-SPT) could be useful for detection of swallowing disorders in elderly patients with stroke, however, there is no report on such a test for detection of symptomless dysphagia. We administered 1 ml technetium Tin Colloid (99mTC) to the patient during sleep via a nasal catheter placed in the mouth. At 09:00 h the next day, symptomless dysphagia was checked for by imaging. Improvement of the symptomless dysphagia was observed, and thus we could prevent the occurrence of aspiration pneumonia. The 99mTC test was particularly useful in detecting symptomless dysphagia in elderly patients with stroke.- - - - - - - - - - ranking = 5.9869456719459keywords = aspiration (Clic here for more details about this article) |
10/267. The use of noninvasive ventilation in acute respiratory failure associated with oral contrast aspiration pneumonitis.noninvasive ventilation (NIV) has been used to treat patients with acute respiratory failure, including cases of pneumonia. We used this technique in the management of an 83-year-old patient with acute respiratory failure secondary to inadvertent administration of oral contrast material into the lung, and who did not want to be intubated. NIV resulted in immediate improvement of respiratory status. The patient was weaned from NIV over the next 24 hours and eventually discharged from the hospital.- - - - - - - - - - ranking = 3.9912971146306keywords = aspiration (Clic here for more details about this article) |
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