Emergency Ventilation Through a Misplaced Esophageal Occlusion Catheter: A Novel Airway Salvage Technique

Background: While esophageal occlusion with urinary catheters shows promise in preventing aspiration, catheter misplacement poses ventilation challenges. This case demonstrates an innovative ventilation salvage technique. Case report: An 80-year-old male with intestinal obstruction and septic shock underwent emergency abdominal surgery. A urinary catheter was mistakenly inserted into the trachea instead of the esophagus, causing severe coughing and reflux. We describe the emergency management strategy using the catheter as an endotracheal tube to maintain ventilation. Results: Mechanical ventilation through the catheter was effective, with stable vital signs and no significant complications. The patient’s condition improved after the obstruction was relieved, and the tracheal tube was replaced successfully. Conclusion: In the absence of a dedicated esophageal sealing device, a double-lumen silicone urinary catheter can be safely and effectively repurposed as an endotracheal tube in emergency situations. This case highlights the importance of preparedness and quick decision-making in managing anesthesia-related complications and underscores the potential utility of alternative tools in critical scenarios.