LEFT BRONCHUS RUPTURE DUE TO A CARLENS TU BE

The authors report a case. of left main bronchus rupture following end otracheal intubation with a Carlens double-lumen tube. The bronchus ru pture occurred during a cure of gastro-oesophageal-reflux and resectio n of oesophageal diverticula through a left thoracotomy. The patient w as a 65-year-old woman treated with corticosteroids for an Addison's d isease. The weakness of the bronchial wall initiated by the steroid ho rmones was an important factor contributing to the perforation. There is also a higher risk of rupture during oesophageal surgery because of surgical dissection and stretch on the tracheobronchial airway. This case demonstrates that such a complication can occur without ventilato ry failure. A rupture must be recognized and treated surgically very r apidly. Recommendations regarding the use of double-lumen endotracheal tubes are reviewed in order to decrease the occurence of such a compl ication.