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Canadian Journal of Anesthesia, Vol 32, 56-59, Copyright © 1985 by Canadian Anesthesiologists' Society

Aspiration during Induction of Anaesthesia in Patients with Colon Interposition

JOHN D. GALLAGHER MD1, DAVID S. SMITH MD PHD1, JOAN MERANZE MS1, SUSAN CRAIG NICOLSON MD1, and RODOLFO I. GODINEZ MD PHD1

1 Department of Anesthesia, University of Pennsylvania and Department of Anesthesia and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

Address correspondence to: Dr. John D. Gallagher, Department of Anesthesiology, Deborah Heart and Lung Center, 1 Trenton Road, Browns Mills, New Jersey 08015.

The risk of aspiration during induction of anaesthesia in patients with oesophageal disease is not well defined, and controversy exists with respect to patients who have undergone pharyngeal-gastric colon interposition. Excellent gastrooesophageal competence has been documented in many of these patients, and propulsive peristalsis has been demonstrated in interposed colonic segments, suggesting that aspiration risk is low. This report, however, describes recent anaesthetic experiences in two patients with colon interpositions and shows that these patients may have markedly redundant interposed segments that retain food or other paniculate residue and, thus, present a significant risk of paniculate aspiration. Awake intubation may be the best approach to avoid aspiration in these patients.

Key Words: COMPLICATIONS: aspiration • SURGERY: colon interposition






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Copyright © 1985 by the Canadian Anesthesiologists' Society.