Oesophageal rupture and cricoid pressure

Cricoid pressure.

PURPOSE Although cricoid pressure (CP) is a superficially simple and appropriate mechanical method to protect the patient from regurgitation and gastric insufflation, in practice it is a complex manoeuvre which is difficult to perform optimally. The purpose of this review is to examine and evaluate studies on the application of (CP). It deals with anatomical and physiological considerations, te...

Cricoid pressure: indications and complications.

Cricoid pressure to occlude the upper end of the oesophagus, also called the Sellick manoeuvre, may be used to decrease the risk of pulmonary aspiration of gastric contents during intubation for rapid induction of anaesthesia. Effective and safe use of the technique requires training and experience. Cricoid pressure is contraindicated in patients with suspected cricotracheal injury, active vomi...

Cricoid pressure: the argument against

Cricoid pressure – friend or foe?

Cricoid pressure was described by Sellick [1] over 40 years ago to reduce the probability of the aspiration of gastric contents onto the pulmonary tree. It subsequently became part of the technique termed rapid sequence intubation and is used in most countries of the world as an integral part of the emergency induction of anaesthesia. Its introduction into clinical practice followed a simple te...

Spontaneous mid-oesophageal rupture.

The clinical presentation and management of spontaneous rupture of the middle third of the oesophagus is described in two patients. Early presentation and treatment in one case led to uncomplicated recovery. In the other patient late presentation and diagnosis resulted in delayed surgical intervention with an unsuccessful outcome. The nature of this rare lesion is discussed and nine previously ...