The Tuberculous Bronchoesophageal Fistula Detected during Induction of General Anesthesia in Brain Abscess Patient
뇌농양 환자에서 전신마취 유도 동안 발견된 결핵성 기관지식도루
박, 관식; 이, 숙영; 민, 상지; 박, 종국; 손, 영표
Taehan Mach'ikwa Hakhoe chi, 53(5):645-651, 2007
Taehan Mach'ikwa Hakhoe chi; The Journal of the Korean Society of Anesthesiologists; 대한마취과학회지
We report a case of bronchoesophageal fistula detected during induction of general anesthesia in brain abscess patient. Bubbling sound at substernal area and gas bubble at oral cavity during manually assisted mask ventilation, especially inspiration, were detected. Barium esophagography, gastroscopy and bronchoscophy were performed to know the nature of fistula after neurosurgical operation. The patient had a bronchoesophageal fistula due to unproperly treated old pulmonary tuberculosis. Esophageal opening of fistula located at midesophagus about 27 cm distance from incisor, while bronchial opening located at apical segment of right superior bronchus. It depends on the size, location, and duration of fistula to manifest clinical symptom. In bronchoesophageal fistula, the size of opening tends to be small and gradual symptom onset while relatively large and early in TEF. Therefore, knowledge of the differences of two types of fistula are essential to manage the patient who have these types of fistula.
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