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

Vamsidhar Vennamaneni¹, Rishbha Dua^1, , 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

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

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