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American Journal of Medical Case Reports. 2022, 10(11), 295-299
DOI: 10.12691/AJMCR-10-11-4
Case Report

Uvular Necrosis after Oral Bronchoscopy with Bronchoalveolar Lavage: A Case Report with Review of Evidence

Vamsidhar Vennamaneni1, Rishbha Dua1, , George Michel2, Virendrasinh Ravat1 and George Yatzkan3

1Department of Internal Medicine, Larkin Community Hospital, 7031 SW 62nd Ave, South Miami, FL 33143

2Department of Science, University of Miami, 1320 S Dixie Hwy, Coral Gables, Fl 33146

3Department of Pulmonary Medicine, Larkin Community Hospital, PalmSprings Campus, 1475 W 49th St, Hialeah, FL 33012

Pub. Date: November 28, 2022

Cite this paper

Vamsidhar Vennamaneni, Rishbha Dua, George Michel, Virendrasinh Ravat and George Yatzkan. Uvular Necrosis after Oral Bronchoscopy with Bronchoalveolar Lavage: A Case Report with Review of Evidence. American Journal of Medical Case Reports. 2022; 10(11):295-299. doi: 10.12691/AJMCR-10-11-4

Abstract

Uvular Necrosis is a relatively rare and unfortunate postprocedural circumstance that can occur following a traumatic oropharyngeal insertion of medical instruments. These medical instruments cause compression of the uvula decreasing vascular supply and leading to necrosis and subsequently sloughing off of the affected area. We present here possibly the first-ever case reported as a rare complication of oral bronchoscopy with bronchoalveolar lavage (BAL) that leads to uvular necrosis. The patient complained of persistent sore throat, odynophagia, and dysphagia one day after the procedure. Uvular necrosis is more commonly reported during nasopharyngeal endoscopies and traumatic blind intubations but is rarely associated with bronchoscopies. Though the inciting event is unclear on this patient whether it was the BAL or the bronchoscope itself, the uvular necrosis was a certainty. With appropriate management, the patient¡¯s symptoms started resolving and the area of necrosis diminished. While symptoms from uvular necrosis typically self-resolve within two weeks with conservative management, it is important to recognize the concern to the provider of life-threatening oropharyngeal edema that can be a sequel of this event.

Keywords

uvular necrosis, oral bronchoscopy with bronchoalveolar lavage, review of evidence

Copyright

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]  AlMomen, H. S., Maufa, F., & AlAwamy, M. (2021: Uvular Necrosis Following Esophagogastroduodenoscopy: A Case Report. American Journal. 22.
 
[2]  Atkinson, C., & Rangasami, J. (2006: Uvula necrosis¡ªan unusual cause of severe postoperative sore throat. British Journal of Anaesthesia. 97:426-427.
 
[3]  Bright, Concha Blamey, Beckmann, et al.: Iatrogenic uvular injury related to airway instrumentation: A report of 13 cases from the webAIRS database and a review of uvular necrosis following inadvertent uvular injury. Anaesthesia and Intensive Care. 49: 133-139.
 
[4]  Budde, A., Parsons, C., & Eikermann, M. (2018: Uvula necrosis after fibreoptic intubation. 120: 1139-1140.
 
[5]  Evans, D. P., & Lo, B. M. (2009: Uvular necrosis after orotracheal intubation. The. American Journal of Emergency Medicine. 27: 631-3.
 
[6]  Goldin, M., & Ji, L. (2013): Uvula Necrosis, an Atypical Presentation of Sore Throat. The. Journal of Emergency Medicine. 44: 185-186.
 
[7]  Iftikhar, M. H., Raziq, F. I., & Laird-Fick, H. (2019): Uvular necrosis as a cause of throat discomfort after endotracheal intubation. BMJ Case Reports. 12: 231227.
 
[8]  Kim-Fine, Casiano, Jankowski, et al.: Uvular necrosis after gynecologic surgery: a case report. Journal of Anesthesiology and Clinical Science. 2: 9.
 
[9]  Shores, N. J., & Bloomfeld, R. S. (2009): Uvular Necrosis after Endoscopy. New England Journal of Medicine. 361: 20.
 
[10]  Smith, Z., & Lobo, S. (2015): Uvular necrosis in an adolescent following general anaesthesia in the prone position. Anaesthesia Cases. 3: 7-11.
 
[11]  Sunio, L. K. F., Contractor, T. A., & Chacon, G. (2011): Uvular Necrosis as an Unusual Complication of Bronchoscopy Via the Nasal Approach. Respiratory Care, 56, 695-697.
 
[12]  Xiao, M., Kaufman, D. I., & Abrams, G. D. (2021): Uvular Necrosis After Shoulder Surgery: A Report of Three Cases.
 
[13]  Leiten, Martinsen, Bakke, et al.: Complications and discomfort of bronchoscopy: a systematic review. European Clinical Respiratory Journal. 3:33324.
 
[14]  Suratt, P. M., Smiddy, J. F., & Gruber, B. (1976): Deaths and Complications Associated with Fiberoptic Bronchoscopy. Chest. 69:747-751.
 
[15]  Cho, Kim, Park, et al.: D., Kim, J. K., & Yoon, J. H. 2017, 39:731-734.
 
[16]  Bogetz, M. S., Tupper, B. J., & Vigil, A. C. (1991). Too Much of a Good Thing: Anesthesia & Analgesia. 72: 125-126.
 
[17]  Treatment and Prevention of Streptococcal Pharyngitis. (2021). Accessed: 06/2022: https://www.uptodate.com/contents/treatment-and-prevention-of-streptococcal-pharyngitis.