Abstract

FERNANDEZ-RAMOS, Humberto et al. Pharyngeal perforation during therapeutic endoscopy procedure. Case report. Rev. colomb. anestesiol. [online]. 2017, vol.45, suppl.1, pp.21-25. ISSN 0120-3347.

The pharynx is a musculomembranous tube common to the upper respiratory tract and the initial segment of the GI tract. Any endoscopic therapeutic procedure requires the participation of a competent anesthetist to secure the patency and control of the airway, upon the induction of general anesthesia that blocks the protective reflexes and hence prevents the passage of the GI contents into the lower respiratory tract. The endoscopist is required to be cautious in the use of the technique to accomplish the objective. A clinical case of a failed endoscopic therapeutic procedure presenting subcutaneous emphysema, suggestive of a perforation is discussed. In order to define the topography and to make a differential diagnosis of the lesion, a clinical signs sequence is conducted that revealed a perforation of the posterior pharynx, then confirmed using endoscopic imaging. An algorithm is suggested to make the differential diagnosis between an intra and an extra-glottic perforation.

Keywords : Subcutaneous emphysema; Endoscopy; Airway management; Intubation; Pharynx.

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