title: [Tracheal rupture as a cause of unanticipated perioperative mortality].
abstract: Here we report two cases in which healthy young patients died during surgery because ventilation was impossible by a clinical picture of massive subcutaneous emphysema. The probable diagnosis was tracheal rupture. This diagnosis was not confirmed during coroner's autopsy, but there had been no systematic search for a puncture in the trachea or the main bronchial tubes. Immediate recognition of this situation, and implementation of ventilation of one lung by pushing a narrower endobronchial tube beyond the tracheal rupture, is potentially life-saving.
authors.affiliation: Universitair Medisch Centrum Utrecht, Afd. Anesthesiologie, Utrecht, the Netherlands. c.j.kalkman@umcutrecht.nl
authors.forename: Cor J
authors.initials: CJ
authors.lastname: Kalkman
authors.forename: Marije
authors.initials: M
authors.lastname: Marsman
authors.forename: J T A Hans
authors.initials: JT
authors.lastname: Knape
authors.forename: Jan G
authors.initials: JG
authors.lastname: van den Tweel
mesh_terms: D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008297:Male; D059035:Perioperative Period; D012421:Rupture / Q000209:etiology; D013352:Subcutaneous Emphysema / Q000209:etiology* / Q000401:mortality; D014132:Trachea / Q000293:injuries* / Q000601:surgery; D055815:Young Adult