Tracheal diverticulum – a possibility of intraoperative and postoperative complications

Abstract

During preoperative anesthesiology examination of a 39 year old female patient, it was noticed a suspected tracheal diverticula, as seen on the CT scan. Bronchoscopy was required to assess the risk of intubation, which did not confirm the presence of the tracheal diverticulum, but a demarcation of the posterior wall of the trachea was observed. Due to a diagnosed kidney tumor, the patient was intubated and operated without complications from the intubation. However postoperatively, in order to confirm the presence of a tracheal diverticulum, the Radiology Clinic was consulted, where a 3D reconstruction of a pre-made CT scan revealed a tracheal diverticulum with dimensions of 1.83 cm x 5.42 mm. Conclusion: Diagnosis of tracheal diverticulum is established with high resolution CT with 1 mm cross sections and 3D reconstruction. Bronchoscopy cannot exclude the presence of tracheal diverticulum. If we have evidence of the presence of a tracheal diverticulum during anesthesiology, it is desirable to determine the level of the tracheal diverticulum to avoid placing the cuff at that level. The airway pressure needs to be strictly controlled and the ventilation mode adequate