Bronchial rupture. Diagnosis and therapy of a rare complication of the use of double-lumen tubes
Jooss, D.; Zeiler, D.; Muhrer, K.; Hempelmann, G.
Der Anaesthesist 40(5): 291-293
1991
ISSN/ISBN: 0003-2417 PMID: 1867370 Document Number: 368198
For anesthesia during thoracic surgery, it is common to use a double-lumen endotracheal tube for one-lung ventilation. Double-lumen tubes protect the bronchial system of the healthy lung from being occluded by blood or pus coming from the operated lung. Therefore, in cases of lung abscess, bronchial hemorrhage, lung cyst, or localized lung infection the use of a double-lumen tube is advisable. Facilitating operation and reduced operating time are further advantages of intubation with a double-lumen tube for independent ventilation of both lungs. Due to the rigidity of these tubes, however, there are disadvantages such as injuries to the trachea and bronchial system. We report a case of rupture of the left main bronchus after insertion of a Carlens tube. The intraoperative symptoms of airway leakage are demonstrated, the process of locating and repairing the injury is described. In our case the postoperative course was not complicated; the patient left the hospital 10 days after operation. Causes of bronchial rupture, its therapy, and prophylactic measures are also discussed.