Gastric Rupture after Failed Intubation for Cesarean Section.

Choi,  Duck Hwan; Choi,  Hyo Sun; Kim,  Jie Ae; Choi,  Joong Sub

doi:2002.43.2.255

Case Report

Korean Journal of Anesthesiology 2002;43(2):255-258.
DOI: https://doi.org/10.4097/kjae.2002.43.2.255

Gastric Rupture after Failed Intubation for Cesarean Section.

Duck Hwan Choi, Hyo Sun Choi, Jie Ae Kim, Joong Sub Choi

¹Department of Anesthesiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. dhchoi@smc.samsung.co.kr
²Department of Obstetrics & Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

A 27-year-old parturient in her gestational age of 38(+4) weeks was admitted to the obstetric emergency room due to fetal distress and suspected pneumoperitoneum after a failed intubation during anesthetic induction for cesarean delivery, which occurred at an obstetric clinic. On admission, she was drowsy, her abdomen was excessively distended, and the fetal heart tone was inaudible. An emergency cesarean section was performed after a standard laryngeal mask airway (size 4) was inserted for general anesthesia. At the moment the peritoneum was opened, a great amount of free air escaped. A floppy baby was delivered with an Apgar score 1 at 1 min and 4 at 5 min. Before transfer to the neonatal intensive care unit, the baby was resuscitated and intubated. Immediately after the cesarean section was completed, an emergency exploratory laparotomy was carried out. During the laparotomy, a linear tear, 8.2 cm long, along the lesser curvature of stomach was identified and repaired. The patient and her baby recovered uneventfully and were dischargedon the 7(th) postoperative day.

Key Words: Difficult airway; failed intubation; cesarean section; gastric rupture; pneumoperitoneum; laryngeal mask airway