RT Journal Article
SR Electronic
T1 Difficult intubation of the esophagus or trachea stent – When cervical muscle contractures combined with the narrowing. Descriptions of cases
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p2414
VO 38
IS Suppl 55
A1 Adam Rzechonek
A1 Jerzy Kolodziej
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p2414.abstract
AB Purpose: The muscle contraction is the main cause of difficulty of tracheal intubation. Self-expanding tube stents are typically placed using a rigid bronchoscope. How to do it by simultaneous occurrence of strictures and the stiff neck.Material: We described 2 cases of patients with received prolonged mechanical ventilation in an intensive care unit. In both patients developed: stiff neck and tracheoesophageal fistula (TEF).The insertion of self-expanding stents has been found successful in both patients.Method: After failed attempts to insert the rigid endoscope, there were temporarily used an oral endotracheal tubes. To put them we used a laryngoscope to visualize the throat, fiberscope's and guides with stringed tubes. By Hegar's method (pushing and replacing tubes in increasingly diameter) were obtained extending of tracheal stenosis or narrowing of pharyngeal sphincter. Then through the intubation tube the adjusted stents were inserted into the trachea or esophagus. Correction or control of positioning of stents ended treatments.Conclusions: Stiff neck and narrowing of the trachea or esophagus, are a significant obstacle in the establishment of the stents. They should be taken into account in planning treatment.Use of fiberscope, guides and intubation tubes of increasing diameters is relative simple and cheap way to solve the problem.