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Abstract
Tracheobronchial rupture after tracheal intubation has been infrequently reported.
We report 6 cases of membranous tracheal rupture after endotracheal intubation treated
at our institution over 7 years.
Overinflation of the tracheal cuff was speculated to be a frequent cause of the tracheal
damage because the lesion was always a linear laceration of the posterior membranous
wall. The diagnosis was suspected on the basis of common signs such as subcutaneous
emphysema, respiratory distress, pneumomediastinum, and pneumothorax. Fiberoptic bronchoscopy
was the best means of confirming the diagnosis and determining the location and extent
of the lesion. In 5 patients, extensive laceration with severe respiratory disorders
required emergent repair through a right posterolateral thoracotomy.
There were two postoperative deaths unrelated to the tracheal lesion. A patient with
a small tracheal defect and favorable clinical presentation showed a rapid positive
outcome after conservative treatment.
Tracheal intubation-related airway ruptures are rare but probably underestimated.
Early recognition and emergent repair are essential, because failure to do so could
result in potentially lethal events.