Iatrogenic Life Threatening Tracheal Tear in Pediatric Patient; A Challenging Case to Manage

Abstract

We present a case in which an 11 month old baby with Johanson-Blizzard Syndrome developed respiratory failure due to respiratory syncytial virus. The baby was intubated and re-intubated several times using different endotracheal tube sizes in an effort to improve ventilation. While in the pediatric intensive care unit, her condition deteriorated and a tear at the posterior wall of the trachea adjacent to the carina was diagnosed. An attempt to correct surgically the tear failed. During that surgery hypoxemia occurred followed by cardiac arrest. The resuscitation that was carried out was successful and the child recovered in the pediatric intensive care unit for several days without additional surgical intervention. We discuss the management of a tracheal tear in the pediatric population, particularly the conservative as opposed to the surgical approach.