Conservative management of iatrogenic tracheal injury

Abstract

Introduction: The difficulties during airway management can lead to iatrogenic tracheal injury. Conservative and surgical treatments are possible treatments. We present the case of a patient with iatrogenic tracheal injury treated conservatively. Case report: 55 years old female patient was transferred to our intensive care unit from a regional health center. Edema compromised airway as a consequence of anaphylactic shock was difficult to establish. Three days after tracheal injury the patient was transported to our institution. At admission, patient was under sedation with trachea intubated with tracheal tube and mechanically ventilated. Physical examination revealed subcutaneous emphysema in the region of head, neck, chest and upper extremities. Multi slice computerized tomography and tracheo-bronchoscopic exploration revealed longitudinal gap localized at posterior wall of the trachea, approximately 5 cm long, with distal end 1.5 cm above the tracheal carina. Tracheal split was completely closed after 13 days. The patient was discharged from the hospital after 22 days. Conclusion: Iatrogenic tracheal injury can be treated successfully using conservative measures after appropriate patient assessment and treatment planning. .