Article Text

Download PDFPDF

CASE REPORT
Endoscopic control of gastric emptying after administration of intravenous erythromycin in an awake patient scheduled for urgent rigid bronchoscopy
  1. Sultan Nawabi1,
  2. Jean-Louis Frossard2,3,
  3. Jerome Plojoux4 and
  4. Christoph Czarnetzki1,3
  1. 1 Division of Anaesthesiology, Geneva University Hospitals, Geneva, Switzerland
  2. 2 Division of Gastroenterology, Geneva University Hospitals, Geneva, Switzerland
  3. 3 Faculty of Medicine, University of Geneva, Geneva, Switzerland
  4. 4 Division of Pneumology, Geneva University Hospitals, Geneva, Switzerland
  1. Correspondence to Dr Christoph Czarnetzki, christoph.czarnetzki{at}hcuge.ch

Abstract

Certain interventional pulmonology procedures such as the placement of a tracheal stent or resection of stenosing tracheal tumours require rigid bronchoscopy under general anaesthesia. Unlike an endotracheal tube with a cuff, the rigid bronchoscope only partially protects the airway from bronchoaspiration. For this reason, this procedure is performed on an elective basis in fasted patients. We describe the case of a 60-year-old man with acute respiratory distress requiring emergent rigid bronchoscopy following distal migration of a tracheal stent. One hour before the procedure, the patient had eaten a full meal. Gastric emptying was accelerated by perfusion of intravenous erythromycin and verified by endoscopy with a small diameter gastric endoscope under local anaesthesia. This 1 min procedure was very well tolerated by the patient and allowed to verify with certainty that the stomach was empty. The urgent rigid bronchoscopy for stent retrieval could then be performed safely without any risk of bronchoaspiration.

  • anaesthesia
  • gastrointestinal system
  • emergency medicine
  • endoscopy

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

View Full Text

Statistics from Altmetric.com

Footnotes

  • Contributors SN drafted the first version of the manuscript and received informed consent from the patient. J-LF is the gastroenterologist who performed the endoscopic control. JP is the pulmonologist of the patient who performed the bronchoscopy. SN and CC are the anaesthesiologists of the patient. CC filmed the endoscopic control and revised the manuscript. J-LF and JP critically revised the manuscript. All authors read and approved the final version of the manuscript​.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.