Abstract
TOPIC: Procedures TYPE: Fellow Case Reports INTRODUCTION: Bronchoscopy can cause post-procedural throat discomfort due to oropharyngeal irritation. We report an unusual complication of bronchoscopy that resulted in a similar presentation. CASE PRESENTATION: A 31-year-old man with a history of myelodysplastic syndrome (MDS) complained of severe throat discomfort, difficulty swallowing, and hoarseness of voice a few minutes after undergoing bronchoscopy for bilateral lung infiltrates. He was thrombocytopenic at 31,000 prior to the procedure; normal coagulation profile; never been on anticoagulation or antiplatelet agents. Bronchoscopy was introduced through the Laryngeal mask airway (LMA), and the procedure lasted less than 15 minutes. Post-procedural suctioning was done.The patient noted hoarseness of voice and difficulty swallowing post-procedure. Physical examination revealed a swollen elongated uvula with a distally located hematoma. The patient received Solumedrol and admitted for observation, subsequently managed conservatively with Tylenol. DISCUSSION: Flexible bronchoscopy is a safe procedure with a low incidence of complications. Our patient had an unusual cause of throat discomfort post-bronchoscopy and he was found to have uvular hematoma secondary to uvular damage with laryngeal mask airway and post-procedural suctioning. CONCLUSIONS: Though uvular hematoma has been described in patients taking antiplatelet agents and with endotracheal intubation, it has not been previously reported in patients with moderate thrombocytopenia and LMA. Careful Suctioning should be done to avoid trauma in patients with thrombocytopenia. REFERENCE #1: Steven M. Weiss.et al. Complications of Fiberoptic Bronchoscopy in Thrombocytopenic Patients. Chest. Volume 104, Issue 4, October 1993, Pages 1025-1028. DISCLOSURES: No relevant relationships by Rajesh Kunadharaju, source=Web Response No relevant relationships by Hiwot Mengiste, source=Web Response No relevant relationships by Musa Saeed, source=Web Response
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