Question:easy
A 27 year old female was brought to the emergency department for acute abdominal pain, following which she was shifted to the operation theatre for laparotomy. A speedy intubation was performed, but after the intubation breath sounds were observed to be decreased on the left side and a high end tidal CO2 was recorded. The likely diagnosis is:
A 27 year old female was brought to the emergency department for acute abdominal pain, following which she was shifted to the operation theatre for laparotomy. A speedy intubation was performed, but after the intubation breath sounds were observed to be decreased on the left side and a high end tidal CO2 was recorded. The likely diagnosis is:
Show Hint
A maintained CO2 trace with one quiet lung means the tube went too deep, not into the gullet.
Updated On: Jun 24, 2026
- Endotracheal tube blockage
- Bronchospasm
- Esophageal intubation
- Endobronchial intubation
Show Solution
The Correct Option is D
Solution and Explanation
Take the two clues one at a time. First, an end tidal CO2 was recorded, which tells you the tube is sitting in the airway. If the tube had slid into the oesophagus, you would see almost no CO2, so you can drop the oesophageal option straight away.
Second, the left lung is quiet while the right is fine. With the tube confirmed in the trachea, a quiet left side after a hurried, fast push usually means the tube went in too far and slipped into the right main bronchus. The right main bronchus is the natural destination because it is wider, shorter and more in line with the trachea, so only the right lung gets ventilated and the left falls silent.
A blocked tube would shut down ventilation altogether and kill the CO2 trace, and bronchospasm would tighten both lungs with wheeze and high pressures, neither of which matches a one-sided quiet chest.
So a deeply placed tube has gone down the right bronchus.
\[\boxed{\text{Endobronchial intubation}}\]
Second, the left lung is quiet while the right is fine. With the tube confirmed in the trachea, a quiet left side after a hurried, fast push usually means the tube went in too far and slipped into the right main bronchus. The right main bronchus is the natural destination because it is wider, shorter and more in line with the trachea, so only the right lung gets ventilated and the left falls silent.
A blocked tube would shut down ventilation altogether and kill the CO2 trace, and bronchospasm would tighten both lungs with wheeze and high pressures, neither of which matches a one-sided quiet chest.
So a deeply placed tube has gone down the right bronchus.
\[\boxed{\text{Endobronchial intubation}}\]
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