JOPIC

The JoPIC is an independent-unbiased, peer-reviewed, and open-access journal of current national and international issues and reviews for original clinical and experimental research, interesting case reports, surgical techniques, differential diagnoses, editorial opinions, letters to the editor, and educational papers in pulmonology, thoracic surgery, occupational diseases, allergology, and intensive care medicine.

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Case Report
Stepwise LMA–fiberoptic bronchoscopy–double-lumen tube airway management for one-lung ventilation in a young patient with pulmonary hydatid cyst: a case report
Airway management in thoracic surgery becomes challenging when the underlying pathology affects the airway, with additional complexity introduced when one-lung ventilation is required for surgical access. This report describes a 19-year-old male with no prior health issues, in whom a routine pre-employment chest radiograph identified a mass in the right upper zone. Further imaging with thoracic computed tomography revealed a 15×7 cm lesion in the right upper lobe's posterior segment, leading to compression of the trachea. The patient was referred for video-assisted thoracoscopic evaluation with an initial diagnosis of cystic lung disease. An airway management plan was prepared preoperatively, including a laryngeal mask airway (LMA), fiberoptic bronchoscope (FOB), bronchial blocker, and double-lumen tube (DLT). After standard monitoring, preoxygenation, and induction with midazolam, fentanyl, and propofol, an LMA was placed, and FOB examination showed near-complete extraluminal obstruction of the right main bronchus, with the left main bronchus remaining patent. The patient underwent video-assisted thoracoscopic surgery (VATS) for cyst resection, and postoperative analgesia was provided via ultrasound-guided erector spinae plane block (ESPB). Histopathological examination of the resected material confirmed the diagnosis of pulmonary hydatid cyst. This step-by-step approach, utilizing LMA, FOB, and DLT sequentially, can effectively maintain airway security in cases where mass-related airway compression complicates lung isolation during thoracic procedures.


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Volume 4, Issue 3, 2026
Page : 88-91
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