title: Iatrogenic tracheal laceration in the setting of chronic steroids.
abstract: We report the case of a 71-year-old woman with end-stage chronic obstructive pulmonary disease who presented with a 10-cm tracheal laceration from a presumed traumatic intubation in the setting of respiratory distress and chronic obstructive pulmonary disease exacerbation and subsequently developed significant subcutaneous emphysema along her neck and mediastinum in addition to her peritoneum and mesentery. We were successfully able to treat this patient conservatively up until the time that tracheostomy was warranted. We discuss and review tracheobronchial injuries with respect to etiology, risk factors, and management and hope to benefit health care providers managing airways in patients at risk for tracheal injury.
authors.affiliation: Department of Anesthesiology, Penn State College of Medicine, Penn State Hershey, Medical Center, Hershey, PA 17033, USA. Electronic address: PunitSingh88@gmail.com.
authors.forename: Punit
authors.initials: P
authors.lastname: Singh
authors.affiliation: Department of Critical Care Medicine, Penn State College of Medicine, Penn State, Hershey Medical Center, Hershey, PA 17033, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Wojnar
authors.affiliation: Department of Anesthesiology, Penn State College of Medicine, Penn State Hershey, Medical Center, Hershey, PA 17033, USA.
authors.forename: Anita
authors.initials: A
authors.lastname: Malhotra
mesh_terms: D000368:Aged; D001999:Bronchoscopy; D018450:Disease Progression; D016145:Endoscopy, Digestive System; D005260:Female; D005774:Gastrostomy / Q000379:methods; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications / Q000209:etiology*; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000295:instrumentation; D022125:Lacerations / Q000139:chemically induced* / Q000000981:diagnostic imaging; D020704:Laryngoscopes / Q000009:adverse effects; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy*; D011859:Radiography; D013352:Subcutaneous Emphysema / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000293:injuries*; D014133:Tracheal Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging; D014139:Tracheostomy / Q000379:methods
chemical_list: D005938:Glucocorticoids
keywords: Subcutaneous emphysema;; Tracheal injury; Tracheal laceration;; Tracheobronchial;; Tracheostomy;; Traumatic intubation;