Document Detail

Case Report: Left Mainstem Bronchial Intubation at an Extremely Short Incisor-to-Carina Distance in a Patient with Severe Ascites.
MedLine Citation:
PMID:  21156976     Owner:  NLM     Status:  In-Data-Review    
Unintentional left mainstem bronchial intubation after direct laryngoscopy is less common than unintentional right mainstem bronchial intubation, having only been referenced 3 times outside of the anesthesia literature. We report a case of unintentional left mainstem intubation at an extremely short incisor-to-carina distance. We hypothesize that the left mainstem intubation occurred because of a distortion of the anatomy of the tracheal bifurcation, caused by the patient's severe ascites, hepatomegaly, and collapsed right lower lobe, thus creating a shallower angle of the left mainstem bronchus from midline. The short incisor-to-carina distance can be explained by ascites-induced cephalad shift of the mediastinum.
Alyssa B Brzenski; Jonathan L Benumof
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Publication Detail:
Type:  Journal Article     Date:  2010-12-14
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  112     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  445-7     Citation Subset:  AIM; IM    
Department of Anesthesiology, UCSD Medical Center, 402 Dickinson St., Suite 2-224, San Diego, CA 92103-8812. jbenumof@ucsd.ed.
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