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Yoon, Ban, Kwon, Oh, Kim, Kim, Lim, Kim, and Song: A Case of Tracheal Carcinoma Diagnosed by Rigid Bronchoscopy in Lidocaine Anaphylaxis Patient
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2009; 67(2): 140-144.

Published online: 31 August 2009

DOI: https://doi.org/10.4046/trd.2009.67.2.140

A Case of Tracheal Carcinoma Diagnosed by Rigid Bronchoscopy in Lidocaine Anaphylaxis Patient

Byeong Kab Yoon, M.D.1, Hee Jung Ban, M.D.1, Yong Soo Kwon, M.D.1, In Jae Oh, M.D.1, Kyu Sik Kim, M.D.1, Yu Il Kim, M.D.1, Sung Chul Lim, M.D.1, Young Chul Kim, M.D.1, Sang Yoon Song, M.D.2

1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.

2Department of Thoracic & Cardiovascular Surgery, Chonnam National University Medical School, Gwangju, Korea.

Address for correspondence: Kyu Sik Kim, M.D. Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, 160, Ilsim-ri, Hwasun-eup, Hwasun-gun, Jeonnam 519-809, Korea. Phone: 82-61-379-7615, Fax: 82-61-379-7628, cyberkks@chonnam.ac.kr

Received 15 July 2009       Accepted 6 August 2009

Copyright©2009. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

The majority of flexible bronchoscopies are performed under topical anesthesia with lidocaine being the most commonly used agent. Anaphylaxis rarely occurs after local administration of lidocaine, but can be a fatal complication. We experienced a case of unexpected anaphylaxis. A 66-year-old woman was scheduled for flexible bronchoscopy to evaluate a tracheal mass and stenosis. The oral and nasal mucosa were pretreated with lidocaine. About 2~3 minutes later, the patient developed hypotension and we treated for anaphylaxis in the emergency room. Then, we decided to perform rigid bronchoscopy in this patient, under conditions of general anesthesia. A rigid bronchoscopy was performed in this patient, safely and successfully. The tracheal mass was determined to be squamous cell carcinoma.

Keywords: Lidocaine anaphylaxis, Rigid bronchoscopy, Flexible bronchoscopy

Figures and Tables

Figure 1
Chest X-ray shows a lower tracheal stenosis (arrow) by circumferential mass.
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Figure 2
Chest computed tomography shows a tracheal stenosis by irregular hypertrophy of lower endotracheal wall.
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Figure 3
(A) Bronchoscopic finding shows a tracheal stenosis by irregular endotracheal mass in lower trachea. (B) This shows Karl Storz endoskope set. (C) This bronchoscopic finding shows that rigid bronchoscopy was performed to reestablish patency of the airway by means of mechanical removal. An arrowhead shows a tip of rigid bronchoscope. (D) Normal orifices of both main bronchi are seen.
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