A Rare Complication: Tracheal Laceration after Routine Intubation at the Tamale Teaching Hospital

Abstract

Patients Tracheal perforation is a rare complication of endotracheal intubation that usually presents as a linear lesion in the membranous wall of the trachea. It is more prevalent in women (because they have shorter stature and a weaker pars membranosa compared to men), patients 50 years and older and patients less than 160 cm tall. Most common clinical manifestations include
subcutaneous emphysema, pneumomediastinum, pneumothorax, respiratory distress and haemoptysis. We report the case of a young male presenting with tracheal perforation after routine endotracheal intubation. This case was managed conservatively
without complications. Possible causes for the injury include: over-inflation of the endotracheal tube cuff, intubation by an inexperienced anaesthetist or use of an inappropriately sized tube for the patient. Clinical suspicion must be followed by diagnostic confirmation, which was achieved by direct visualization of trachea rupture on bronchoscopy. We therefore encourage endotracheal tube cuff pressure monitoring during general anaesthesia and direct supervision of an inexperienced anaesthetists during critical events such as induction and intubation.