Tracheal Rupture After Endotracheal Intubation: Experience with Management in 13 Cases

Abstract

Background: Tracheal rupture is a rare complication of endotracheal intubation. Potential causes, diagnosis, management, and outcome of cases treated at an university hospital are analysed. Patients and Methods: This is a retrospective report on thirteen cases of tracheal rupture related to tracheal intubation, treated at our institution from February 1989 to May 2002. In all patients, the tracheal rupture was confirmed by fiberoptic bronchoscopy. Results: Eleven patients underwent primary repair through a right thoracotomy. Three postoperative deaths unrelated to the tracheal lesion occurred. All remaining cases showed an uneventful recovery after surgical therapy. Two lacerations of the cervical part of the trachea were treated nonsurgically with a satisfactory outcome. Conclusions: Prognosis of tracheal ruptures depends both on the underlying disease and general condition of the patient and on the rapidity of diagnosis and treatment. Surgical therapy is preferred as it allows reconstruction of the trachea and drainage of the mediastinum. Conservative management appears to be justified for small ruptures in the upper third of the trachea without mediastinitis.

Key words

Tracheal rupture - intubation - mediastinitis - endotracheal tube

References

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