Iatrogenic post-intubation tracheal rupture treated conservatively without intubation: a case report

Bertrand Prunet, Guillaume Lacroix, Yves Asencio, Olivier Cathelinaud, Jean-Philippe Avaro, Philippe Goutorbe, Bertrand Prunet, Guillaume Lacroix, Yves Asencio, Olivier Cathelinaud, Jean-Philippe Avaro, Philippe Goutorbe

Abstract

Background: Tracheal rupture is a rare but life-threatening complication that most commonly occurrs after blunt trauma to the chest, but which may also complicate tracheal intubation. We report a case of post-intubation tracheal rupture after cataract surgery under general anesthesia treated conservatively.

Case presentation: Four hours after extubation, a 67 year-old woman developed subcutaneous emphysema of the facial, bilateral laterocervical and upper anterior chest. Tracheobronchial fiberendoscopy showed a posterior tracheal transmural rupture 4 cm long located 2.5 cm above the carina that opened in inspiration. The location of the lesion and features of the patient favoured conservative treatment with antibiotic cover. The patient made a full and uncomplicated recovery and was discharged fourteen days after the original injury.

Conclusion: Two therapeutic strategies are currently employed for post-intubation tracheal rupture: a non-surgical strategy for small injuries and a surgical strategy for larger injuries. This case report presented the non-surgical therapeutic strategy of a large tracheal injury.

Figures

Figure 1
Figure 1
Thoracic CT showing diffuse soft tissues emphysema of the neck.
Figure 2
Figure 2
Thoracic CT showing mediastinal emphysema.
Figure 3
Figure 3
Thoracic CT showing posterior tracheal rupture (Arrow).
Figure 4
Figure 4
Posterior tracheal rupture.

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Source: PubMed

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