Life-threatening airway obstruction caused by angioedema in a morbidly obese postoperative patient: a case report

JA Clinical Reports

Satoki Inoue¹  Makiko Konda¹  Yusuke Naito¹  Junji Egawa¹  Masahiko Kawaguchi¹ 

[1] Division of Intensive Care and Department of Anesthesiology, Nara Medical University;

关键词: Angioedema;    Angiotensin-converting enzyme inhibitor;    Enalapril;    Difficult airway;   

DOI  :  10.1186/s40981-020-00408-6

来源: DOAJ

【 摘 要 】

Abstract Background We report a case of a morbidly obese patient who developed life-threatening airway obstruction due to angioedema. Case presentation A 50-year-old Japanese morbidly obese female was treated with enalapril for 10 years, with no history of angioedema. After 3 h of completion of breast cancer resection under general anesthesia with tracheal intubation, she developed airway obstruction and respiratory arrest. Her oral cavity was occupied with a swollen tongue. It was extremely difficult to determine the airway anatomical orientation although tracheal intubation was attempted using a videolaryngoscope. At this time, she probably started gasping respiration, which generated a faint bubble and revealed a possible airway. Her airway was established using a tracheal tube without confirming the glottis or the vocal cord. Conclusions Angioedema induced by angiotensin-converting enzyme (ACE) inhibitors is rare; however, once it occurs, it can be potentially life threatening, especially for patients with possible difficult airway. Considering the risk–benefit ratio, we must be careful in administering ACE inhibitor therapy in morbidly obese patients.

【 授权许可】

Unknown