We report a case of rupture of the left main bronchus in a female patient with oesophageal carcinoma, who had received thoracic radiotherapy preoperatively. Endotracheal intubation was achieved with a left-sided double-lumen tube. After almost three hours of intubation and one and half hours of one-lung ventilation, bronchial injury was detected. Immediate surgical repair of the membranous part of the bronchus was undertaken, as well as completion of the oesophagectomy. Radiotherapy-induced damage to the bronchus was thought to have contributed to the rupture. The presentation, diagnosis and management of intraoperative bronchial rupture are discussed.
WagnerD.L., GammageG.W., WongM.L.Tracheal rupture following the insertion of a disposable double lumen endotracheal tube.Anesthesiology1985; 63: 698–700.
6.
KleinD.S., WildsP.R.Pulmonary toxicity of antineoplastic agents: Anaesthetic and postoperative implications.Can Anaesth Soc J1983; 30: 399–405.
7.
LeslieM.D., NapierM., GlaserM.G.Pneumothorax as a complication of tumor response to chemotherapy.Clin Oncol1993; 5: 181–182.
8.
LibshitzH.I., BannerM.P.Spontaneous pneumothorax as a complication of radiation therapy to the thorax.Radiology1974; 112: 199–201.
9.
BurtonN.A., FallS.M., LyonsT., GraeberG.M.Rupture of the left main-stem bronchus with a polyvinylchloride double-lumen tube.Chest1983; 83: 928–929.
10.
BorasioP., ArdissoneF., ChiampoG.Post-intubation tracheal rupture. A report on ten cases.Eur J Cardiothorac Surg1997; 12: 98–100.
11.
SakuragiT., KumanoK., YasumoroM., DanK.Rupture of left main-stem bronchus by the tracheal portion of a double lumen endobronchial tube.Acta Anaesthesiol Scand1997; 41: 1218–1220.
12.
GuytonD.C., BesselievreT.R., DevidasM., DeLimaL.G.R., EichornJ.H.A comparison of two different bronchial cuff designs and four different bronchial cuff inflation methods.J Cardiothorac Vasc Anesth1997; 11: 599–603.
