caa a22 4500 445374012 CHVBK 20180317142956.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s00540-011-1150-3 doi (NATIONALLICENCE)springer-10.1007/s00540-011-1150-3 A case of serious laryngeal edema unpredictably detected during laryngoscopy for orotracheal intubation following induction of anesthesia [Elektronische Daten] [Yukari Koga, Yasunori Mishima, Mayu Saho, Asuka Ito, Takahiko Ito, Teruyuki Hiraki, Kazuo Ushijima] We report a case of unpredictable and serious laryngeal edema probably caused by preoperative esophagogastroduodenoscopy (EGD). A 54-year-old man with type 2 diabetes mellitus was scheduled to undergo coronary artery bypass grafting (CABG). Two days before surgery, EGD was performed to explore the cause of occult bleeding, resulting in a slightly sore throat and an increased white blood cell count (18,300/μl). Without premedication, general anesthesia was uneventfully induced with intravenous midazolam (10mg) and fentanyl (50μg), followed by inhalation of sevoflurane (3%) and intravenous rocuronium (50mg). Thereafter, manual ventilation was easily performed with a bag and mask. However, on laryngoscopy for orotracheal intubation, serious swelling with rubor and light pus in the epiglottis extending to the arytenoid cartilage was detected, leading to the cancellation of surgery. Immediately following intravenous drip of hydrocortisone (300mg) and bolus of sugammadex (200mg), the patient recovered smoothly from anesthesia without complications such as dyspnea, but his sore throat persisted. He was diagnosed with acute epiglottitis. Treatment consisted of intravenous cefazolin (2g/day) and hydrocortisone (300mg/day tapered to 100mg/day) for 9 consecutive days. Consequently, the patient recovered gradually from the inflammation and underwent CABG as scheduled 28days later. Anesthesiologists should be aware that EGD performed just before anesthesia could unpredictably cause acute epiglottitis, especially in immunocompromised patients, such as those with diabetes. Japanese Society of Anesthesiologists, 2011 Laryngeal edema nationallicence Esophagogastroduodenoscopy nationallicence Complications nationallicence Acute epiglottitis nationallicence Koga Yukari Department of Anesthesiology, Kurume University School of Medicine, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan aut Mishima Yasunori Department of Anesthesiology, Kurume University School of Medicine, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan aut Saho Mayu Department of Anesthesiology, Kurume University School of Medicine, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan aut Ito Asuka Department of Anesthesiology, Kurume University School of Medicine, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan aut Ito Takahiko Department of Anesthesiology, Kurume University School of Medicine, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan aut Hiraki Teruyuki Department of Anesthesiology, Kurume University School of Medicine, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan aut Ushijima Kazuo Department of Anesthesiology, Kurume University School of Medicine, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan aut Journal of Anesthesia Springer Japan 25/4(2011-08-01), 589-591 0913-8668 25:4<589 2011 25 540 https://doi.org/10.1007/s00540-011-1150-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-011-1150-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Koga Yukari Department of Anesthesiology, Kurume University School of Medicine, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan aut NATIONALLICENCE 700 1- Mishima Yasunori Department of Anesthesiology, Kurume University School of Medicine, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan aut NATIONALLICENCE 700 1- Saho Mayu Department of Anesthesiology, Kurume University School of Medicine, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan aut NATIONALLICENCE 700 1- Ito Asuka Department of Anesthesiology, Kurume University School of Medicine, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan aut NATIONALLICENCE 700 1- Ito Takahiko Department of Anesthesiology, Kurume University School of Medicine, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan aut NATIONALLICENCE 700 1- Hiraki Teruyuki Department of Anesthesiology, Kurume University School of Medicine, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan aut NATIONALLICENCE 700 1- Ushijima Kazuo Department of Anesthesiology, Kurume University School of Medicine, 67 Asahi-machi, 830-0011, Kurume, Fukuoka, Japan aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/4(2011-08-01), 589-591 0913-8668 25:4<589 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer