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BJA Advance Access published online on March 11, 2005
British Journal of Anaesthesia, doi:10.1093/bja/aei124
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journal.permissions@oupjournals.org
Accepted February 11, 2005

Case Report

Gastric rupture after awake fibreoptic intubation in a patient with laryngeal carcinoma

C.-M. Ho 1*, I.-W. Yin 1, K.-F. Tsou 1, L.-H. Chow 1, and S.-K. Tsai 1

1 Department of Anaesthesiology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan

* To whom correspondence should be addressed.
C.-M. Ho, E-mail: cmho{at}vghtpe.gov.tw


  Abstract

An 86-yr-old man with recurrent laryngeal carcinoma developed gastric rupture after awake fibreoptic intubation before induction of general anaesthesia. Early clinical signs included a distended, tense and tympanic abdomen with pain and massive pneumoperitoneum (chest radiograph). Laparotomy revealed a 4-cm longitudinal perforation along the lesser curvature of the stomach. This case represents a rare but severe complication that may occur during fibreoptic intubation in the awake patient.

Keywords: complications, gastric rupture; complications, intraoperative; complications, stomach rupture; intubation, fibreoptic; intubation, tracheal.
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