Elsevier

The Annals of Thoracic Surgery

Volume 94, Issue 3, September 2012, Pages 1001-1003
The Annals of Thoracic Surgery

Case report
Tracheal Stent to Repair Tracheal Laceration After a Double-Lumen Intubation

https://doi.org/10.1016/j.athoracsur.2011.12.080Get rights and content

A 59-year-old woman was referred for a diagnostic video thoracoscopy under general anesthesia. At the end of the procedure, the patient presented with subcutaneous emphysema and cyanosis, abdominal distension, and bradycardia. A rigid bronchoscopy showed a longitudinal laceration in the pars membranacea of the trachea. A tracheal silicon stent was positioned on an emergency basis. She was intubated, positioning the tracheal tube cuff distal of the stent under bronchoscopic vision. A computed tomographic scan performed immediately after the procedure showed left pneumothorax, pneumoperitoneum, pneumopericardium, and diffuse subcutaneous emphysema. The subsequent course of the patient was uneventful. The patient was discharged home on postoperative day 4. After 1 year, the stent was removed with the evidence of complete trachel healing.

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Comment

Tracheal laceration is a rare but life-threatening complication of intubation with a double-lumen tube. The occurrence of this complication seems to be higher in females with mild to severe obesity [4], as it occurred in the case presented. In addition to injuries that can occur during tube placement, cuff-related ruptures in the intubated and mechanically ventilated patient may also develop. Considering the site of tracheal laceration, it is likely that the cause of the damage could be an

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