Conservative Management of Large Tracheal Perforation due to Traumatic Intubation

Abstract

Tracheal perforation is a rare complication of intubation and is associated with high mortality. Here we describe a case of large, full-thickness tracheal perforation from traumatic intubation after an elective procedure. The injury was managed with prolonged intubation that bypassed the site of injury, and the patient was successfully extubated after 11 days. Conservative management of tracheal perforation after traumatic intubation is an option in select patients that avoids need for surgery.

Spontaneous tracheal perforation following a sneeze

“…Only a few cases of spontaneous tracheal perforations have been reported 2 4. More commonly, tracheal perforations are caused by either iatrogenic or traumatic injuries following a thyroidectomy, traumatic intubation, percutaneous tracheostomy procedure, insertion of an oesophageal stent, oesophageal corrosive injury and sharp and blunt trauma 1 3 5–19. Tracheal perforations may be managed conservatively but often require surgical intervention.…”

“…Tracheal perforations may be managed conservatively but often require surgical intervention. This may depend on whether a patient is haemodynamically stable or unstable—based on vital signs being within or outside of normal limits—as well as the site of the perforation 4 5 7 9 10 16 17. Schneider et al performed a retrospective analysis of 29 patients with iatrogenic tracheobronchial injuries 20.…”