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Paediatric anaesthesia · Sep 2007
Case ReportsA rapidly advancing mediastinal mass--overcoming tracheobronchial obstruction.
- Ian Frost, Rob Ross-Russell, Sam Bass, and Amos Burke.
- Department of Anaesthesia, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. ian@ianfrost.wanadoo.co.uk
- Paediatr Anaesth. 2007 Sep 1;17(9):893-6.
AbstractWe report the case of a 7-year-old boy who presented with rapidly advancing airway obstruction secondary to mediastinal T-cell non-Hodgkins lymphoma. His brisk deterioration required transfer to the pediatric intensive care unit and intubation of the trachea. Unforeseen unilateral bronchial involvement led to gas trapping and critical pulmonary hyperinflation. Endobronchial advancement of the tracheal tube beyond the bronchial obstruction relieved pulmonary hyperinflation but subsequent one lung ventilation was poorly tolerated. We report the manufacture of a proximal 'Murphy's eye' which allowed ventilation of the contralateral lung to proceed. To the best of our knowledge this is the first time that this technique has been described in a pediatric patient.
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