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

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.