Author/Authors :
Kim, Hee Young Departments of Anesthesia and Pain Medicine - Pusan National University Yangsan Hospital - Yangsan, Korea , Baek, Seung-Hoon Departments of Anesthesia and Pain Medicine - Pusan National University Yangsan Hospital - Yangsan, Korea , Cho, Yong Hoon Departments of - Surgery - Pusan National University Yangsan Hospital - Yangsan, Korea , Kim, Joo-Yun Departments of Anesthesia and Pain Medicine - Pusan National University Yangsan Hospital - Yangsan, Korea , Choi, Yun Mi Departments of Anesthesia and Pain Medicine - Pusan National University Yangsan Hospital - Yangsan, Korea , Choi, Eun Ji Departments of Anesthesia and Pain Medicine - Pusan National University Yangsan Hospital - Yangsan, Korea , Yoon, Jung Pil Departments of Anesthesia and Pain Medicine - Pusan National University Yangsan Hospital - Yangsan, Korea , Park, Jung Hyun Departments of Anesthesia and Pain Medicine - Pusan National University Yangsan Hospital - Yangsan, Korea
Abstract :
In pediatric patients, a laryngeal mask airway (LMA) is usually used during minor surgeries
that require general anesthesia. No esophageal injury has been reported after insertion of an
LMA. We report a case of an esophageal injury with intramural dissection after an i-gel® (size,
1.5; Intersurgical Ltd.) insertion in a pediatric patient. A 2-month-old male infant was hospitalized for left inguinal herniorrhaphy. After induction of anesthesia, a trained resident tried to
insert an i-gel®. However, it was only successful after three attempts. Dysphagia was sustained until postoperative day 10, and the pediatrician observed duplication of the esophagus
on gastroendoscopy. However, a whitish mucosal lesion, which looked like a scar, was observed, and previous lesions suggestive of esophageal duplication were almost healed on
postdischarge day 11. His condition was diagnosed as dysphagia and esophagitis due to an
esophageal laceration, not esophageal duplication. He was scheduled for symptomatic treatment with a proton pump inhibitor. In conclusion, although an esophageal injury or perforation in pediatric patients is rare, an LMA insertion or a procedure such as aspiration or nasogastric tube insertion should be performed gently to avoid a possible injury to the esophagus
in pediatric patients.
