Intraoperative Rupture of Hydatid Cyst Membrane: A Flexible Rhino-laryngoscope Innovation to the Rescue
Published: October 1, 2018 | DOI: https://doi.org/10.7860/JCDR/2018/31450.12136
Nishant Sahay, Umesh Kumar Bhadani, Poonam Kumari
1. Assistant Professor, Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, India.
2. Professor and Head, Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, India.
3. Senior Resident, Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, India.
Correspondence
Dr. Nishant Sahay,
House No. 112, Type 4 Block 1, AIIMS Residential Complex, Khagaul-801105, Patna, India.
E-mail: nishantsahay@gmail.com
The present case report describes a catastrophe avoided during operative removal of hydatid cyst located in the lower lobe of left lung. The intrabronchial hydatid cyst membranes ruptured intraoperatively and were aspirated in the bronchi. The aspiration caused collapse of left upper lobe of lung. In the absence of flexible fibre optic or rigid bronchoscope for airway management, this potentially dangerous condition was diagnosed and successfully managed innovatively using a rhino-laryngoscope. An improvised arrangement using a paediatric suction catheter with its distal end cut and secured by adhesive paper to a rhino-laryngo fibrescope was made. This arrangement of suction catheter attached to a rhino-pharyngo-laryngoscope was then used to remove more than four pieces of membranes of hydatid cyst under direct vision from the tracheobronchial tree preventing an airway catastrophe. The case report thus highlights importance of quick thinking and effective resource management even in resource limited settings.
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