Iatrogenic tracheal laceration in the setting of chronic steroids

J Clin Anesth. 2017 Feb:37:38-42. doi: 10.1016/j.jclinane.2016.10.043. Epub 2016 Dec 22.

Abstract

We report the case of a 71-year-old woman with end-stage chronic obstructive pulmonary disease who presented with a 10-cm tracheal laceration from a presumed traumatic intubation in the setting of respiratory distress and chronic obstructive pulmonary disease exacerbation and subsequently developed significant subcutaneous emphysema along her neck and mediastinum in addition to her peritoneum and mesentery. We were successfully able to treat this patient conservatively up until the time that tracheostomy was warranted. We discuss and review tracheobronchial injuries with respect to etiology, risk factors, and management and hope to benefit health care providers managing airways in patients at risk for tracheal injury.

Keywords: Subcutaneous emphysema;; Tracheal injury; Tracheal laceration;; Tracheobronchial;; Tracheostomy;; Traumatic intubation;.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bronchoscopy
  • Disease Progression
  • Endoscopy, Digestive System
  • Female
  • Gastrostomy / methods
  • Glucocorticoids / adverse effects*
  • Glucocorticoids / therapeutic use
  • Humans
  • Iatrogenic Disease
  • Intraoperative Complications / etiology*
  • Intubation, Intratracheal / adverse effects*
  • Intubation, Intratracheal / instrumentation
  • Lacerations / chemically induced*
  • Lacerations / diagnostic imaging
  • Laryngoscopes / adverse effects
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / diagnostic imaging
  • Pulmonary Disease, Chronic Obstructive / drug therapy
  • Pulmonary Disease, Chronic Obstructive / therapy*
  • Radiography
  • Subcutaneous Emphysema / etiology*
  • Tomography, X-Ray Computed
  • Trachea / injuries*
  • Tracheal Diseases / chemically induced*
  • Tracheal Diseases / diagnostic imaging
  • Tracheostomy / methods

Substances

  • Glucocorticoids