Gastric rupture after awake fibreoptic intubation in a patient with laryngeal carcinoma

Abstract

An 86-yr-old man with recurrent laryngeal carcinoma developed gastric rupture after awake fibreoptic intubation before induction of general anaesthesia. Early clinical signs included a distended, tense and tympanic abdomen with pain and massive pneumoperitoneum (chest radiograph). Laparotomy revealed a 4-cm longitudinal perforation along the lesser curvature of the stomach. This case represents a rare but severe complication that may occur during fibreoptic intubation in the awake patient. © The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved.