Iatrogenic Tracheal Rupture Caused by Emergency Intubation: A Case Report

J Emerg Med. 2018 Jul;55(1):e15-e18. doi: 10.1016/j.jemermed.2018.02.014. Epub 2018 Apr 22.

Abstract

Background: Iatrogenic tracheal rupture is a rare but life-threatening complication. If suspected by clinical examination or chest radiograph, a computed tomography scan can confirm the diagnosis, but the criterion standard is a bronchoscopy. There is no consensus on its management.

Case report: A 52-year-old woman was intubated in a prehospital setting after cardiac arrest. A gradual appearance of subcutaneous emphysema was observed after intubation. A computed tomography scan revealed a complicated tracheal rupture, pneumomediastinum, and pneumothorax. The management was surgical. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Intubation in emergency conditions increases the risk of tracheal rupture and a delay in management is an important prognostic factor.

Keywords: prehospital; subcutaneous emphysema; tracheal intubation; tracheal rupture.

Publication types

  • Case Reports

MeSH terms

  • Airway Management / adverse effects
  • Airway Management / methods
  • Female
  • Humans
  • Iatrogenic Disease
  • Intubation, Intratracheal / adverse effects*
  • Intubation, Intratracheal / standards
  • Middle Aged
  • Radiography / methods
  • Rupture / complications
  • Rupture / diagnosis*
  • Rupture / etiology*
  • Subcutaneous Emphysema / diagnosis
  • Subcutaneous Emphysema / diagnostic imaging
  • Subcutaneous Emphysema / etiology
  • Tomography, X-Ray Computed / methods
  • Trachea / diagnostic imaging
  • Trachea / injuries*
  • Trachea / physiopathology