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Abstract

Tracheal perforation is a rare complication of intubation. In the pediatric population, the rates of morbidity and mortality are high if diagnosis and management are delayed. Recommendations for treatment in these patients are based on the several reports of this injury in the adult and neonate populations. Surgical repair is generally favored over conservative care in the majority of cases. We describe the case of a 10-year-old girl who presented with subcutaneous emphysema after intubation in the emergency department. The patient had a 3-cm injury to the distal trachea. Nonsurgical management resulted in a normal-appearing trachea and a healed perforation site as confirmed by repeat tracheobronchoscopy 4 months after the initial injury. In clinically stable pediatric patients, nonsurgical management of tracheal perforations should be considered.

Keywords

bronchoscopy intubation injury tracheal perforation

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References

Goudy

Miller

Bumpous

. Neck crepitance: Evaluation and management of suspected upper aerodigestive tract injury. Laryngoscope 2002;112:791–5.

Westphal

Lischke

Byhahn

. Posterior tracheal wall perforation with the Blue Rhino tracheostomy set. Anaesthesia 2002;57:89–90.

Trottier

Hazard

Sakabu

. Posterior tracheal wall perforation during percutaneous dilational tracheostomy: An investigation into its mechanism and prevention. Chest 1999;115:1383–9.

Menon

Carlin

Kaplan

. Tracheal perforation. A complication associated with transtracheal oxygen therapy. Chest 1993;104:636–7.

Marty-Ane

Picard

Jonquet

Mary

. Membranous tracheal rupture after endotracheal intubation. Ann Thorac Surg 1995;60:1367–71.

Harris

Joseph

. Acute tracheal rupture related to endotracheal intubation: Case report. J Emerg Med 2000;18:35–9.

Zettl

Waydhas

Biberthaler

. Nonsurgical treatment of a severe tracheal rupture after endotracheal intubation. Crit Care Med 1999;27:661–3.

Santambrogio

Nosotti

Cioffi

De Simone

Pavoni

Testori

. Extended membranous tracheobronchial rupture after endotracheal intubation. Int Surg 1998;83:106–7.

Borasio

Ardissone

Chiampo

. Post-intubation tracheal rupture. A report on ten cases. Eur J Cardiothorac Surg 1997;12:98–100.

10.

D'Odemont

Pringot

Goncette

Goenen

Rodenstein

. Spontaneous favorable outcome of tracheal laceration. Chest 1991;99:1290–2.

11.

Doherty

Tabaee

Castillo

Cherukupally

. Neonatal tracheal rupture complicating endotracheal intubation: A case report and indications for conservative management. Int J Pediatr Otorhinolaryngol 2005;69:111–6.

12.

Sternfeld

Wright

. Tracheal rupture and the creation of a false passage after emergency intubation. Ann Emerg Med 2003;42:88–92.

13.

Othersen

Jr . Intubation injuries of the trachea in children. Management and prevention. Ann Surg 1979;189:601–6.

14.

Baena

M Fernandez

Jurado

MI Fernandez

. Conservative management of tracheal rupture after intubation. Paediatr Anaesth 1997;7:325–7.

15.

Moller

ten Berge

Stassen

. Tracheocele: A rare cause of difficult endotracheal intubation and subsequent pneumomediastinum. Eur Respir J 1994;7:1376–7.

16.

MacKinnon

. Tracheal diverticula. J Pathol Bacteriol 1953;65:513–7.

17.

Scholl

. Adult tracheocele. Otolaryngol Head Neck Surg 1994;111:519–21.

18.

Weymuller

Jr . Prevention and management of intubation injury of the larynx and trachea. Am J Otolaryngol 1992;13:139–44.

Nonsurgical Management of Pediatric Tracheal Perforation

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