Unexpected upper airway obstruction due to disseminated human papilloma virus infection involving the pharynx in a parturient

Acta Anaesthesiologica Taiwanica : Official Journal of the Taiwan Society of Anesthesiologists
Yuet-Tong NgPeter Chi Ho Chung

Abstract

Human papilloma virus has been implicated as the cause of juvenile-onset recurrent respiratory papillomatosis in first-born children. Thus, cesarean section is strongly recommended by obstetricians to avoid direct contact with papilloma in an infected birth canal. We report a parturient with silent hypopharyngeal papilloma, which was associated with severe clinical problems at the induction of general anesthesia. The anesthesiologist considered general anesthesia for this case because of disseminated skin warts and secondary pus across the patient's body. Although the patient's breathing was smooth before starting general anesthesia, it was difficult to maintain positive pressure ventilation despite administration of a muscle relaxant. High air-way resistance without chest wall motion was noted, despite the insertion of an oral airway. Therefore, direct laryngoscopy was immediately performed and an obstructing mass was found. This mass acted as a check valve during positive ventilation. Our report should remind clinicians that human papilloma virus infection, although benign, can be disastrous in certain circumstances, as in our case where it resulted in airway obstruction and distal spread during cesarean section. Its presence...Continue Reading

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Citations

Oct 29, 2013·Indian Journal of Anaesthesia·Vishnu Panwar, Pramod Kohli
Jun 9, 2016·The Journal of International Medical Research·Jeong Jin MinJong-Hwan Lee

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