Unexpected folding of the endobronchial segment of double-lumen tube during intubation: A case report

Son, Hyo Jung; Oh, Jin Young; Kim, Wook Jong; Jin, Ji Hyun; Lee, Eun Ho; Choi, In Cheol

Case Report

Cardiothoracic and Vascular Anesthesia

Anesthesia and Pain Medicine 2011;6(2):154-156.
Published online April 30, 2011.

Unexpected folding of the endobronchial segment of double-lumen tube during intubation: A case report

Hyo Jung Son, Jin Young Oh, Wook Jong Kim, Ji Hyun Jin, Eun Ho Lee, In Cheol Choi

Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. icchoi@amc.seoul.kr

Abstract

The double-lumen tube is widely used in various kinds of cardiothoracic surgery as a facilitation for easier procedures. Silbroncho(R) (Fuji systems, Tokyo, Japan) double-lumen tube, which is made of flexible silicone material, reduces injury to the tracheal and bronchial mucosa during intubation. The bronchial lumen is wire-reinforced to maintain tip angulation and prevent bending or obstruction. However, its increased flexibility resulted in distortion, especially when we encountered resistance to passage. We document an unusual complication case which involved folding of the endobronchial segment of the double-lumen tube after blind intubation in difficult airways.

Key Words: Complication, Double-lumen tube, Unexpected folding