An unexpected airway complication of cystoscopy secondary to a jejeno-vesical fistula

An unexpected airway complication of cystoscopy secondary to a jejeno-vesical fistula

Published: 04 Jan 2018

© Anaesthesia Cases / 2017-0238 / ISSN 2396-8397

Authors

Dr Benjamin Kolb [1]
Dr Ming Wilson [2]
  • [1] Registrar, Anaesthesia, Salford Royal Foundation Trust, Manchester, United Kingdom
  • [2] Consultant, Anaesthesia, Salford Royal NHS Foundation Trust, Manchester, United Kingdom

Summary

A 44-year-old male underwent routine cystoscopy after presenting with faecaluria. The rare diagnosis of a jejuno-vesical fistula secondary to actinomycosis was incidentally discovered upon finding pressurised irrigation fluid pouring at high velocity from the patients mouth and nose. This article discusses the airway challenges presented by the case. Massive pulmonary aspiration ensued that was managed by a short period of positive pressure ventilation and antibiotics. Following recovery from the respiratory insult, the patient underwent a laparotomy and successful repair of the jejuno-vesical fistula.

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