Membranous tracheal stenosis in a patient with anorexia nervosa and self-induced vomiting- challenges in securing the airway
We report a rare case of acquired membranous tracheal stenosis in a patient with anorexia nervosa and a history of self-induced vomiting, but without a history of tracheal intubation or tracheostomy. A 50-year-old woman presented with difficulty in breathing and swallowing, self-expectoration, and i...
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| Format: | Article |
| Language: | English |
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Elsevier
2017-01-01
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| Series: | Respiratory Medicine Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213007117300357 |
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| author | Motohiro Nakamura, MD, PhD Masaki Hisamura, MD, PhD Masayuki Hashimoto, MD Makoto Sawano, MD PhD Midori Joshita, MD Takahiro Toi, MD Yoshitaka Asano, MD Hideyo Matsueda, MD Fumihito Arima, MD Hidenori Oi, MD Takehiro Kitawaki, ME Yoji Ando, MD Kenji Koshimizu, MD, PhD |
| author_facet | Motohiro Nakamura, MD, PhD Masaki Hisamura, MD, PhD Masayuki Hashimoto, MD Makoto Sawano, MD PhD Midori Joshita, MD Takahiro Toi, MD Yoshitaka Asano, MD Hideyo Matsueda, MD Fumihito Arima, MD Hidenori Oi, MD Takehiro Kitawaki, ME Yoji Ando, MD Kenji Koshimizu, MD, PhD |
| author_sort | Motohiro Nakamura, MD, PhD |
| collection | DOAJ |
| description | We report a rare case of acquired membranous tracheal stenosis in a patient with anorexia nervosa and a history of self-induced vomiting, but without a history of tracheal intubation or tracheostomy. A 50-year-old woman presented with difficulty in breathing and swallowing, self-expectoration, and impaired consciousness due to acute benzodiazepine intoxication. Bronchoscopic examination was performed after tracheotomy and placement of a tracheostomy tube failed to secure her respiratory tract and ventilation continued to deteriorate. A flap-like membranous structure was identified on the posterior tracheal wall, obstructing the tracheostomy tube. Physical compression of the membranous structure improved ventilation. Bronchoscopic examination is generally recommended prior to performing tracheostomy in patients suspected to have post-intubation tracheal obstruction. Based on our findings, we suggest that these examinations should also be performed in patients with conditions associated with chronic irritation of the respiratory tract, including those with a prolonged history of self-induced vomiting. |
| first_indexed | 2024-12-11T08:04:41Z |
| format | Article |
| id | doaj.art-e2cb8545fbd5467c830ab498c8588273 |
| institution | Directory Open Access Journal |
| issn | 2213-0071 |
| language | English |
| last_indexed | 2024-12-11T08:04:41Z |
| publishDate | 2017-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Respiratory Medicine Case Reports |
| spelling | doaj.art-e2cb8545fbd5467c830ab498c85882732022-12-22T01:15:02ZengElsevierRespiratory Medicine Case Reports2213-00712017-01-0121C363810.1016/j.rmcr.2017.03.012Membranous tracheal stenosis in a patient with anorexia nervosa and self-induced vomiting- challenges in securing the airwayMotohiro Nakamura, MD, PhD0Masaki Hisamura, MD, PhD1Masayuki Hashimoto, MD2Makoto Sawano, MD PhD3Midori Joshita, MD4Takahiro Toi, MD5Yoshitaka Asano, MD6Hideyo Matsueda, MD7Fumihito Arima, MD8Hidenori Oi, MD9Takehiro Kitawaki, ME10Yoji Ando, MD11Kenji Koshimizu, MD, PhD12Department of Emergency Medicine, Saitama Medical Centre, Saitama Medical University, Kamoda Kawagoe City, Saitama, JapanDepartment of Emergency Medicine, Saitama Medical Centre, Saitama Medical University, Kamoda Kawagoe City, Saitama, JapanDepartment of Emergency Medicine, Saitama Medical Centre, Saitama Medical University, Kamoda Kawagoe City, Saitama, JapanDepartment of Emergency Medicine and Critical Care, Saitama Medical Centre, Saitama Medical University, Kamoda Kawagoe City, Saitama, JapanDepartment of Emergency Medicine, Saitama Medical Centre, Saitama Medical University, Kamoda Kawagoe City, Saitama, JapanDepartment of Emergency Medicine, Saitama Medical Centre, Saitama Medical University, Kamoda Kawagoe City, Saitama, JapanDepartment of Emergency Medicine, Saitama Medical Centre, Saitama Medical University, Kamoda Kawagoe City, Saitama, JapanDepartment of Emergency Medicine, Saitama Medical Centre, Saitama Medical University, Kamoda Kawagoe City, Saitama, JapanDepartment of Emergency Medicine and Critical Care, Saitama Medical Centre, Saitama Medical University, Kamoda Kawagoe City, Saitama, JapanDepartment of Emergency Medicine and Critical Care, Saitama Medical Centre, Saitama Medical University, Kamoda Kawagoe City, Saitama, JapanDepartment of Emergency Medicine, Saitama Medical Centre, Saitama Medical University, Kamoda Kawagoe City, Saitama, JapanDepartment of Emergency Medicine, Saitama Medical Centre, Saitama Medical University, Kamoda Kawagoe City, Saitama, JapanDepartment of Emergency Medicine, Saitama Medical Centre, Saitama Medical University, Kamoda Kawagoe City, Saitama, JapanWe report a rare case of acquired membranous tracheal stenosis in a patient with anorexia nervosa and a history of self-induced vomiting, but without a history of tracheal intubation or tracheostomy. A 50-year-old woman presented with difficulty in breathing and swallowing, self-expectoration, and impaired consciousness due to acute benzodiazepine intoxication. Bronchoscopic examination was performed after tracheotomy and placement of a tracheostomy tube failed to secure her respiratory tract and ventilation continued to deteriorate. A flap-like membranous structure was identified on the posterior tracheal wall, obstructing the tracheostomy tube. Physical compression of the membranous structure improved ventilation. Bronchoscopic examination is generally recommended prior to performing tracheostomy in patients suspected to have post-intubation tracheal obstruction. Based on our findings, we suggest that these examinations should also be performed in patients with conditions associated with chronic irritation of the respiratory tract, including those with a prolonged history of self-induced vomiting.http://www.sciencedirect.com/science/article/pii/S2213007117300357Tracheal membranous obstructionTracheotomyBronchoscopyAnorexia nervosa |
| spellingShingle | Motohiro Nakamura, MD, PhD Masaki Hisamura, MD, PhD Masayuki Hashimoto, MD Makoto Sawano, MD PhD Midori Joshita, MD Takahiro Toi, MD Yoshitaka Asano, MD Hideyo Matsueda, MD Fumihito Arima, MD Hidenori Oi, MD Takehiro Kitawaki, ME Yoji Ando, MD Kenji Koshimizu, MD, PhD Membranous tracheal stenosis in a patient with anorexia nervosa and self-induced vomiting- challenges in securing the airway Respiratory Medicine Case Reports Tracheal membranous obstruction Tracheotomy Bronchoscopy Anorexia nervosa |
| title | Membranous tracheal stenosis in a patient with anorexia nervosa and self-induced vomiting- challenges in securing the airway |
| title_full | Membranous tracheal stenosis in a patient with anorexia nervosa and self-induced vomiting- challenges in securing the airway |
| title_fullStr | Membranous tracheal stenosis in a patient with anorexia nervosa and self-induced vomiting- challenges in securing the airway |
| title_full_unstemmed | Membranous tracheal stenosis in a patient with anorexia nervosa and self-induced vomiting- challenges in securing the airway |
| title_short | Membranous tracheal stenosis in a patient with anorexia nervosa and self-induced vomiting- challenges in securing the airway |
| title_sort | membranous tracheal stenosis in a patient with anorexia nervosa and self induced vomiting challenges in securing the airway |
| topic | Tracheal membranous obstruction Tracheotomy Bronchoscopy Anorexia nervosa |
| url | http://www.sciencedirect.com/science/article/pii/S2213007117300357 |
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