AUTHOR=Xiong Jun , Zhou Quan , Li Yu , Sun Yanyan , Zhang Yajun TITLE=Unexpected curious cause of serious air leakage after endotracheal intubation: A case report of tracheobronchomegaly and literature review JOURNAL=Frontiers in Surgery VOLUME=9 YEAR=2022 URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.961186 DOI=10.3389/fsurg.2022.961186 ISSN=2296-875X ABSTRACT=Purpose

Tracheobronchomegaly (TBM) is a rare disease with enlarged trachea and mainstem bronchi, which might not be diagnosed preoperatively because of patient’s nonsymptoms or clinicians’ overlook. These patients would be at fatal risk after general anesthesia endotracheal intubation due to severe peritubal leakage. This case may provide a helpful and informative resource for anesthesiologists and other clinicians, especially those managing patients’ airways.

Clinical feature

We presented a patient undergoing elective scoliosis orthopedics who was postoperatively diagnosed with TBM. After general anesthesia endotracheal intubation, difficulty in maintaining ventilation with obvious peri-cuff air leakage made this rare disease to be suspected. The peritubal leakage was resolved by relocating the endotracheal tube to the subglottic area. Fortunately, there were no air leakage and postoperative complications.

Conclusion

Anesthesiologists should keep the possibility of the unpredicted anatomic abnormal respiratory tract in mind, such as TBM.