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Korean J Crit Care Med > Volume 27(2); 2012 > Article
Korean Journal of Critical Care Medicine 2012;27(2): 115-119. doi: https://doi.org/10.4266/kjccm.2012.27.2.115
유착성 장폐색증 환자에서 마취 유도중에 발생한 위 내용물 흡인에 의한 대량 미만성 폐포 출혈-증례 보고-
정지선ㆍ전종헌ㆍ송효진ㆍ유희구
한양대학교 의과대학 마취통증의학교실
Massive Diffuse Alveolar Hemorrhage Caused by the Aspiration of Gastric Contents during Induction of Anesthesia in Patients with Adhesive Ileus: A Case Report
Ji Seon Jeong, Jong Hun Jun, Hyo Jin Song, Hee Koo Yoo
Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea. jhjun@hanyang.ac.kr
ABSTRACT
Aspiration pneumonitis is best defined as an acute lung injury, following the aspiration of regurgitated gastric contents. Major cause of pulmonary aspiration, during anesthesia, is gastric contents. Pulmonary aspiration can present symptoms of wheezing, coughing, dyspnea, cyanosis, pulmonary edema, hypotension, and hypoxemia, which may progress rapidly to severe acute respiratory distress syndrome (ARDS). However, there was no report of massive alveolar hemorrhage associated with aspiration pneumonitis. A 63-year-old man, who had undergone a total gastrectomy and received adjuvant chemotherapy, four months ago, was scheduled for adhesiolysis of the small bowel. The patient occurred aspiration of gastric contents, during induction of anesthesia, and subsequently, hypoxia developed during surgery. The patient moved to an intensive care unit (ICU), without extubation. Mechanical ventilation with PEEP was performed in an ICU. However, the patient died by ARDS and massive alveolar hemorrhage.
Key Words: acute respiratory distress syndrome; aspiration pneumonitis; diffuse alveolar hemorrhage
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