Abstract
Tracheal rupture is a very rare complication of endotracheal intubation and anterior tears become extremely rare. It is associated with potentially devastating complications which increases perioperative mortality and morbidity. We report a young maternal patient who sustained an anterior tracheal tear complicated with subcutaneous emphysema, pneumomediastinum, bilateral tension pneumothoraces and two episodes of peri arrest. We emphasize on it's risk factors, importance of early diagnosis and practical approach of management. She was conservatively managed in a general ICU and had a successful outcome without sequelae.
Highlights
Iatrogenic tracheal rupture is a rare complication of general anaesthesia
High index of clinical suspicion is the key to diagnosis
Tracheal rupture is traditionally being managed with surgical repair.[1]
Summary
Iatrogenic tracheal rupture is a rare complication of general anaesthesia. Endotracheal intubation is the commonest[1,5] cause of iatrogenic tracheal rupture which typically involves posterior tracheal wall.[2]. Patient may be asymptomatic or complicated with subcutaneous emphysema, respiratory insufficiency with pneumothorax and cardiac compromise with pneumo mediastinum. Case report A previously well, 19-year-old primi mother (height 148cm) with breech presentation in labour presented for emergency LSCS During preoperative assessment she was devoid of pregnancy related medical problems but found to have acute upper and lower respiratory tract infections. Clinical suspicion of tracheal rupture was made excluding other possibilities of subcutaneous emphysema. Anaesthesia was deepened with inhalational agents and patient was transferred to ICU within 10-15 minutes without extubating for further management. Continuous air leakage from tear was excluded clinically with subsiding subcutaneous emphysema and resolving pneumothorax. Intercostal drains were removed on Day 3 and patient was discharged to ward on 4th day after successful management of tracheal rupture without sequalae. Patient was discharged from the ward on Day 07 with complete recovery
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
