[Iatrogenic tracheal rupture: a case report and indications for conservative management].

Revista portuguesa de pneumologia

PubMedID: 16669134

Guerra MS, Miranda JA, Caiado A, Almeida J, Moura e Sá J, Leal F, Vouga L. [Iatrogenic tracheal rupture: a case report and indications for conservative management]. Rev Port Pneumol. 2006;12(1):71-8.
Tracheal rupture after endotracheal intubation requires immediate intervention. There have been an increasing number of reports that describe nonsurgical management of this issue. We report the case of a 47-year-old woman who experienced an iatrogenic tracheal rupture during endotracheal intubation for a surgical procedure with general anaesthesia. She was successfully managed conservatively with a broad-spectrum antibiotic. We managed it non-operatively, because the patient had a small tear, was hemodynamically stable, show no evidence of infection or respiratory failure, and the diagnosis was not immediate. Bronchoscopy was a good diagnostic tool and it was used to make decisions regarding conservative management, and to detect granulation tissue and rule out any tracheal stenosis after treatment. We review available literature on conservative management of tracheal rupture. Immediate recognition and adequate treatment are very important in managing this potentially fatal situation. The final decision should be based on clinical, radiologic and bronchoscopic findings.