Hypoxia during general anesthesia? Unknown foreign body aspiration. 2016

Ozgur Senturk, and Demet Unal, and Onur Selvi
Anaesthesiology and Reanimation, Maltepe University, Istanbul, Turkey. Electronic address: drozgur2003@yahoo.com.

An 18-month-old male patient, classified as American Society of Anesthesiologists I, with bilateral inguinal hernia was scheduled for operation. Preanesthetic evaluation revealed history of completed medical treatment of acute bronchitis 10 days ago, and his respiratory examination was recorded as normal. He was successfully operated under general anesthesia with a laryngeal mask. After removal of the laryngeal mask, he displayed signs of hypoxia. Respiratory sounds were undetectable in the left thorax. He was intubated due to failure of adequate ventilation. Positive pressure ventilation and bronchodilators were administered to provide sufficient ventilation. In his chest X-ray, total atelectasis was determined in the left lung. Pleural effusion was ruled out with thoracic ultrasonography. Diagnostic rigid bronchoscopy was performed, and in left bronchial tree, hazelnut fragments were removed. The patient's hemodynamic and respiratory parameters recovered quickly after foreign body removal, and the patient was transferred to intensive care unit. His parents were questioned for persistent respiratory symptoms and they gave information about repeating respiratory tract infections in the last 3 months. We predict that displaced foreign body in lobar bronchus due to mechanical ventilation can cause this condition.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007431 Intraoperative Complications Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure. Peroperative Complications,Surgical Injuries,Complication, Intraoperative,Complication, Peroperative,Injuries, Surgical,Complications, Intraoperative,Complications, Peroperative,Injury, Surgical,Intraoperative Complication,Peroperative Complication,Surgical Injury
D008297 Male Males
D012121 Respiration, Artificial Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2). Ventilation, Mechanical,Mechanical Ventilation,Artificial Respiration,Artificial Respirations,Mechanical Ventilations,Respirations, Artificial,Ventilations, Mechanical
D012135 Respiratory Sounds Noises, normal and abnormal, heard on auscultation over any part of the RESPIRATORY TRACT. Breathing Sounds,Crackles,Lung Sounds,Pleural Rub,Rales,Rhonchi,Stridor,Wheezing,Breathing Sound,Crackle,Lung Sound,Pleural Rubs,Rale,Respiratory Sound,Rhonchus,Rub, Pleural,Sound, Breathing,Sound, Lung,Sound, Respiratory,Sounds, Breathing,Sounds, Lung,Stridors,Wheezings
D002944 Circumcision, Male Excision of the prepuce of the penis (FORESKIN) or part of it. Male Circumcision,Circumcisions, Male,Male Circumcisions
D005547 Foreign Bodies Inanimate objects that become enclosed in the body. Foreign Objects,Gossypiboma,Retained Surgical Instruments,Retained Surgical Items,Retained Surgical Needle,Retained Surgical Sponge,Retained Surgical Tools,Textiloma,Bodies, Foreign,Body, Foreign,Foreign Body,Foreign Object,Gossypibomas,Object, Foreign,Objects, Foreign,Retained Surgical Instrument,Retained Surgical Item,Retained Surgical Needles,Retained Surgical Sponges,Retained Surgical Tool,Surgical Instrument, Retained,Surgical Instruments, Retained,Surgical Item, Retained,Surgical Items, Retained,Surgical Needle, Retained,Surgical Needles, Retained,Surgical Sponge, Retained,Surgical Sponges, Retained,Surgical Tool, Retained,Surgical Tools, Retained,Textilomas
D006552 Hernia, Inguinal An abdominal hernia with an external bulge in the GROIN region. It can be classified by the location of herniation. Indirect inguinal hernias occur through the internal inguinal ring. Direct inguinal hernias occur through defects in the ABDOMINAL WALL (transversalis fascia) in Hesselbach's triangle. The former type is commonly seen in children and young adults; the latter in adults. Inguinal Hernia,Inguinal Hernia, Direct,Inguinal Hernia, Indirect,Direct Inguinal Hernia,Direct Inguinal Hernias,Hernia, Direct Inguinal,Hernia, Indirect Inguinal,Hernias, Direct Inguinal,Hernias, Indirect Inguinal,Hernias, Inguinal,Indirect Inguinal Hernia,Indirect Inguinal Hernias,Inguinal Hernias,Inguinal Hernias, Direct,Inguinal Hernias, Indirect
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000768 Anesthesia, General Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery. Anesthesias, General,General Anesthesia,General Anesthesias

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