Tracheal rupture after endotracheal intubation: experience with management in 13 cases.
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.


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.
Department of Surgery, University of Bonn, Bonn, Germany.
M
M
Sippel
C
C
Putensen
A
A
Hirner
M
M
Wolff
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012421:Rupture / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D016019:Survival Analysis; D013908:Thoracotomy; D014132:Trachea / Q000293:injuries* / Q000601:surgery*; D014133:Tracheal Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D016896:Treatment Outcome