Tongue engorgement with prolonged use of the esophageal-tracheal combitube

We report a case of massive tongue engorgement associated with placement of an esophageal-tracheal twin-lumen airway device (Combitube) in a morbidly obese patient. Approximately 4 hours after atraumatic placement of the Combitube, tongue swelling occurred. An emergency tracheostomy was needed for a...

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Bibliographic Details
Published inAnnals of emergency medicine Vol. 44; no. 4; pp. 320 - 322
Main Authors McGlinch, Brian P., Martin, David P., Volcheck, Gerald W., Carmichael, Stephen W.
Format Journal Article
LanguageEnglish
Published New York, NY Mosby, Inc 01.10.2004
Elsevier
Subjects
Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Emergency and intensive care: techniques, logistics
Emergency and intensive respiratory care
Esophagus
Female
Humans
Intensive care medicine
Intubation - adverse effects
Intubation - instrumentation
Intubation, Intratracheal - adverse effects
Medical sciences
Perfusions. Catheterizations. Hyperbaric oxygenotherapy
Tongue - blood supply
Tongue Diseases - etiology
Tongue
Intensive care
Digestive system
Resuscitation
Esophagus
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Summary:We report a case of massive tongue engorgement associated with placement of an esophageal-tracheal twin-lumen airway device (Combitube) in a morbidly obese patient. Approximately 4 hours after atraumatic placement of the Combitube, tongue swelling occurred. An emergency tracheostomy was needed for airway management before removal of the Combitube. Ischemia-reperfusion injury or compression of glossal blood vessels, specifically lingual veins, was the most likely cause for the patient's tongue engorgement. An exhaustive search for other causes revealed nothing. Prolonged use of the Combitube may incur greater risk of airway complications such as tongue engorgement.
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ISSN:0196-0644
1097-6760
DOI:10.1016/j.annemergmed.2004.05.022