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Can One Be Affected By Aspiration Pneumonia During A Four Hour Operation?

Posted on Wed, 17 Dec 2014

Question: I am having a hysterectomy, pelvic prolapse repaired and bladder fix. I have had postmenopasal bleeding on and off for two yrs. MY CONCERN IS THIS: I am having everything repaired on XXXXXXX 7, 15 BUT, I have had aspiration pneumonia 5 times during short procedures. Will I not get this during a 4 hr. operation, w ho do I talk to, what dr. should see about this. My mother died from this and my friend at work just had a hysto. and died from aspiration. Since my GYN failed to add. this post menopausal bleeding I must have the operation. So, will I die from possibly uterine cancer since my GYN didn't care or ASPIRTATIONAL PNEUMONIA?????????????????

Answered by Dr. Timothy Raichle (1 hour later)

Brief Answer:
Avoid general anesthesia, Anesthesia consult

Detailed Answer:
Your story is remarkable and there should be serious concern about aspiration. This can occur under general anesthesia when you can not "protect" your airway on your own. Also, consider that if you have had normal biopsies of the uterine lining, and ultrasounds do not show evidence or concerns for cancer, then the surgery is really not for bleeding, but rather for prolapse. Here is what you need to do:

1. You need a formal consult with an Anesthesiologist
2. You need to discuss with them your past and what the concerns would be with an additional procedure
3. Ask them (AND your OB/GYN) about doing this procedure under a spinal anesthetic - you would have complete pain control AND be awake, able to protect your own airway.

Please let me know what you think about this.

Dr. Tim

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Timothy Raichle (2 hours later)

1 1/2 yrs. ago I had a normal D&C with hystoscope. The uragyn that is doing my surgery now tells me since reviewing my previous procedures that on the first vag. ultra. he sees 1" thickness, 2nd vag. ultra. 2" thickness and the 3rd which was a yr. ago he saw a 3" thickness, the that GYN left town, Igot my orig. GYN. back now in Sept. bc when all this began in 2012 she was on vac. She said she had to to another D&C hystoscope since it has been a yr. and a half. She perforated my uterus. But on the endometrial biopsy she like all the rest of my biopsies could not get enough tissue althought the urogyn. said the report said glandular crowding. He told me all of the was worrisome to him. I WILL HAVE A FORMAL CONSULT WITH MY ANETHESIOLOGIST AND BELIEVE ME WITH MY UROGYN. He said Ishould have had the surgery 2 yrs. ago, AGAIN, I am so scared of the pneumonia and that I have bledfor 2 yrs.

Answered by Dr. Timothy Raichle (6 hours later)

Brief Answer:
You are on the right track

Detailed Answer:
Given the persistent postmenopausal bleeding and biopsy showing "glandular crowding" (They did not say cancer), you definitely need your uterus out. They just need to make sure that you do not have cancer BEFORE they do this hysterectomy. It would not be unreasonable to also ask about an ultrasound-guided endometrial biopsy if this has not been done in the last 6 months. Regardless, the meeting with the Anesthesiologist will be very important.

Good luck!

Dr. Tim

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E