Spontaneous rupture of trachea treated conservatively: A case report

Abstract

Introduction and importance Spontaneous rupture of the trachea is a rare, life-threatening condition. Spontaneous rupture associated with corticosteroid use has been rarely reported in the literature. Case presentation We report a case of a 17-year-old male, a known case of nephrotic syndrome managed by corticosteroid treatment, who presented with diffuse neck and chest swelling after forceful coughing resulting in a spontaneous rupture of the trachea. The diagnosis was established using radiological imaging. The patient was managed conservatively with significant improvement and was discharged shortly. Clinical discussion Prolonged use of corticosteroids may lead to spontaneous rupture of the trachea due to tracheal wall weakness. Radiological imaging followed by bronchoscopy can be used to confirm the diagnosis. Management can either be conservative or surgical, depending on the case. Conclusion Conservative treatment by pain relief, intravenous fluids, and antibiotics should be considered an alternative to surgery in selected patients.

Spontaneous tracheal perforation following a sneeze

“…Spontaneous tracheal perforation is a rare, potentially life-threatening condition 1–3. 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. 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.…”

Traumatische tracheobronchiale Verletzungen – Empfehlung der interdisziplinären Arbeitsgruppe der DGT und DGU zur Etablierung einer einheitlichen Klassifikation für Diagnostik und Therapie

“…Neben dieser Entität treten vor allem iatrogen bedingte Verletzungen auf. Daneben werden spontane Rupturen sehr selten beschrieben [4,5]. All diese sind gekennzeichnet durch mehr oder weniger große Unterbrechungen der Oberflächenkontinuität bis hin zum vollständigen Abriss, die sich durch Blutungen innerhalb oder außerhalb der Luftwege, sonstige Verlegungen, Luftansammlung im Gewebe (Weichteilemphysem, Pneumomediastinum, Pneumothorax) oder auch offenen Luftübertritt in die Umgebung manifestieren können.…”