Impossible Airway: A Case Report
Abstract Background: Wheezing is a common presentation of asthma and chronic obstructive pulmonary disease (COPD). However, other rare etiologies such as endotracheal tumor should be kept in mind. Case presentation: We report a case of mucoepidermoid carcinoma of carina in which the patient initially presented with wheezing mimicking COPD. Chest roentgenogram showed a soft-tissue density in the tracheal air column. Surgical resection of the tumor was technically hindered by difficulty in airway establishment during anesthesia. Extracorporeal membrane oxygenation (ECMO) was employed to secure adequate blood-gas exchange during operation, after which the tumor was resected smoothly and the patient discharged uneventfully.Conclusions: Endotracheal tumor should be kept in mind when facing a patient presenting with wheezing. Careful auscultation and interpretation of the chest roentgenogram are two important keys for differentiating such lesions from asthma or COPD. If further intervention was hindered by difficulty in airway establishment, ECMO proves effective and safe to “bypass” such an impossible airway and secure the procedures.
