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Canadian Journal of Anesthesia, Vol 46, 688-691, Copyright © 1999 by Canadian Anesthesiologists' Society

ARTICLES

A novel intubation technique for tracheoesophageal fistula in adults

CL Au, SA White and RP Grant
Department of Anaesthesia, Vancouver General Hospital, University of British Columbia, Canada.

PURPOSE: To describe a novel technique of tracheal intubation and ventilation in an adult patient with a large tracheoesophageal fistula at the level of the carina. CLINICAL FEATURES: A 59 yr old woman with squamous cell carcinoma of the esophagus developed a large (2 cm diameter) tracheoesophageal fistula after radiotherapy. The level of her fistula precluded traditional use of a double-lumen endobronchial tube. Intubation and ventilation were managed with two endobronchial tubes. The ability to ventilate or collapse each lung individually was preserved and anesthesia and surgery proceeded uneventfully. CONCLUSION: Double endobronchial intubation is described to manage anesthesia in an adult patient with a tracheoesophageal fistula at the level of the carina.


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Copyright © 1999 by the Canadian Anesthesiologists' Society.