passage and malpositioning of the tube to the hook are some of the potential problems related with left-sided\r\nCarlens double lumen tube (DLT). This article reports an amputation of the hook during a difficult selective\r\nintubation and aimed at calling the attention to complications associated with DLTs and the importance of\r\nfiberoptic bronchoscopy.\r\nCase presentation: A 68 year-old woman was scheduled for right-sided thoracotomy in whom blind DLT insertion\r\nwas performed. Narrowed trachea causes difficulty in rotating the DLT 90�° counter-clockwise. After carinal hook\r\nwas noticed upon visual inspection of the DLT, fiberoptic bronchoscopy was used to remove the missing part\r\n(with the use of forceps) from the right mainstem bronchus.\r\nConclusion: Insertion of DLTs with carinal hook is associated with technical problems and potentially lifethreatening\r\nhazards have discouraged their use. Fiberoptic evaluation and repositioning solves most of the\r\nproblems. Although amputation of the carinal hook has not been previously reported, clinicians should be alert.\r\nThis case report emphasizes the utility of the fiberoptic bronchoscopy in the operating theatre for placement,\r\npositioning and inspection of the carinal hook DLT.
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