Pharyngeal reperforation following incentive spirometry: A case report.
10.17085/apm.2018.13.4.463
- Author:
Soeun JEON
1
;
Jeong Min HONG
;
Jae Young KWON
;
Boo Young HWANG
;
Giyoung YUN
Author Information
1. Department of Anesthesia and Pain Medicine, Pusan National University Hospital, Busan, Korea. ccarrot@pusan.ac.kr
- Publication Type:Case Report
- Keywords:
Head and neck surgery;
Incentive spirometer;
Incentive spirometry;
Pharyngeal perforation;
Steroids
- MeSH:
Aged;
Emergencies;
Esophagus;
Female;
Head;
Humans;
Hypopharynx;
Intensive Care Units;
Motivation*;
Neck;
Respiration, Artificial;
Rupture;
Spirometry*;
Steroids;
Subcutaneous Emphysema;
Ventilator Weaning;
Wound Healing
- From:Anesthesia and Pain Medicine
2018;13(4):463-467
- CountryRepublic of Korea
- Language:English
-
Abstract:
Despite its widespread use, complication of incentive spirometry has been rarely reported. We report a case of pharyngeal reperforation following incentive spirometry. A 75-year-old female, had a history of long-term steroid use, entered the intensive care unit for maintenance of mechanical ventilation following surgical repair of a pharyngeal perforation. After ventilator weaning, incentive spirometry was implemented on postoperative day 4. Immediately after incentive spirometry use, patient's neck began to swell, and subcutaneous emphysema was palpated. Pharyngeal reperforation was suspected on neck computed tomography, and emergency surgery was performed. Surgery revealed a 3-cm long rupture from the hypopharynx to the esophagus. The causes were thought to be delayed wound healing due to long-term steroid use and a sudden increase in pharyngeal pressure due to incentive spirometry. In conclusion, particular attention should be paid when using incentive spirometry after head and neck surgery in patients with a history of long-term steroid use.
