Anesthetic Management Using a Laryngeal Mask Airway in a Child With Congenital Bronchial Atresia
Congenital bronchial atresia is a relatively rare malformation that causes a segmental obstruction of the bronchus during the fetal period. The peripheral lung distal from the obstructed bronchus becomes hyperinflated because of the unidirectional flow through collateral check-valve entry. Positive pressure ventilation during general anesthesia may cause a rupture of the bulla, resulting in pneumothorax. An 8-year-old girl, who had to undergo oral surgery, was diagnosed as having congenital bronchial atresia and one-fifth of her lung was poorly ventilated. We planned to perform general anesthesia under spontaneous respiration using a laryngeal mask, which was well tolerated.

Preoperative chest radiograph. A mass shadow (a) in the upper left lung field is surrounded by hyperlucent lung field.

Chest computed tomography. A hyperinflated lobe distal from an occluded bronchus was confirmed, suggesting a mucoid impaction (b) in the occluded bronchus.
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