Tracheobronchial injuries following endotracheal intubation

Gibbaoui H, Abu-Zidan FM, Yaman M
Correspondence: Prof Fikri Abu-Zidan, fabuzidan@uaeu.ac.ae

ABSTRACT
We report two rare cases of tracheobronchial injury (TBI) following endotracheal intubation. Both intubations were easy and performed by experienced anaesthetists. The injuries for both cases were possibly caused by the tip of an endotracheal tube. A 27-year-old woman regurgitated copiously during induction of general anaesthesia for a Caesarean section. She had a full-thickness TBI 2 cm above the carina, which was repaired through an open thoracotomy. A 68-year-old woman undergoing left mastectomy was intubated with a 7.5-mm endotracheal tube for general anaesthesia. 24 hours after extubation, the patient developed widespread subcutaneous emphysema. There was no associated respiratory distress, and the patient was treated conservatively. The fragile tracheal tissue associated with pregnancy and old age was possibly a contributing factor for injury. Both patients recovered well. Surgical and non-surgical methods can be safely used after careful consideration of the patient’s clinical, radiological and endoscopic findings.

Keywords: complications, injuries, intratracheal, intubation, trachea
Singapore Med J 2011; 52(5): e96-e99