Tracheal injury characterized by subcutaneous emphysema and dyspnea after improper placement of a Sengstaken-Blakemore tube: A case report

Medicine (Baltimore). 2018 Jul;97(30):e11289. doi: 10.1097/MD.0000000000011289.

Abstract

Rationale: Tracheal injury characterized by subcutaneous emphysema and dyspnea can occur following the use of a Sengstaken-Blakemore tube. Should tracheal injury occur, it may be possible to manage resultant airway obstruction with a tracheal stent.

Patient concerns: We describe the case of a 51-year-old patient who developed a tracheal injury when a Sengstaken-Blakemore tube was inadvertently inserted into the patient's trachea.

Diagnoses: Liver cirrhosis, gastric-fundus variceal bleeding, tracheal injury.

Interventions: Polyglycol and tissue glue were injected intravenously, and endoscopic variceal ligation was performed. A Sengstaken-Blakemore tube was used to stop the bleeding. A covered tracheal stent was placed via fiberoptic bronchoscopy to relieve the tracheal injury due to improper placement of a Sengstaken-Blakemore tube.

Outcomes: After placement of the tracheal stent, the patient was able to breathe spontaneously and subsequently recovered.

Lessons: Some precautions must be taken to avoid placing a Sengstaken-Blakemore tube in the trachea. If a tracheal injury occurs following misplacement of a Sengstaken-Blakemore tube, it may be possible to manage resultant airway obstruction by placing a tracheal stent.

Publication types

  • Case Reports

MeSH terms

  • Airway Obstruction* / etiology
  • Airway Obstruction* / physiopathology
  • Airway Obstruction* / therapy
  • Balloon Occlusion / adverse effects*
  • Balloon Occlusion / methods
  • Dyspnea / etiology
  • Esophageal and Gastric Varices / surgery*
  • Esophagoscopy / adverse effects*
  • Esophagoscopy / instrumentation*
  • Esophagoscopy / methods
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / therapy*
  • Hemostasis, Surgical / adverse effects
  • Hemostasis, Surgical / instrumentation
  • Hemostasis, Surgical / methods
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications* / etiology
  • Postoperative Complications* / therapy
  • Stents
  • Subcutaneous Emphysema / diagnosis
  • Subcutaneous Emphysema / etiology
  • Subcutaneous Emphysema / therapy
  • Trachea / injuries*
  • Tracheal Diseases / diagnosis
  • Tracheal Diseases / etiology
  • Tracheal Diseases / therapy
  • Treatment Outcome