Pediatric penetrating oropharyngeal trauma
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This case presented the anesthetic dilemma of mananging a full stomach and near complete obstruction of the oral airway. It is important to consider that the patient would likely have aspirated had he vomited, even though he was alert and had intact protective airway reflexes when he presented, as the nasal airway was too small to remove stomach contents. Also, as the penetrating oropharyngeal trauma may have caused major vascular injuries as a lateral soft palate or peritonsillar injury could have posed a potential risk to the internal carotid artery injury,1 a CT scan was urgently conducted. Had a vascular injury been suspected, CT angiography could have further identified its extent.2 Based on this patient’s CT scan, if he had started to vomit before commencing surgery, we would have immediately removed the chopstick and corncob to protect the airway, despite the potential risk of hemorrhage.
We are grateful to Guoming Xie MD, PhD, MSc who provided feedback on this paper.
This manuscript was supported by the Natural Science Foundation of Zhejiang Province Y17C09009).
This submission was handled by Dr. Hilary P. Grocott, Editor-in-Chief, Canadian Journal of Anesthesia.
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