Pneumomediastinum and pneumoperitoneum due to iatrogenic tracheal rupture
Diagnosis almost certain
Presentation
Respiratory distress after postoperative tracheal extubation.
Patient Data
Age: 35 years
Gender: Female
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The CT scan demonstrates:
- defect of the posterior tracheal wall measuring 9 mm
- pneumomediastinum extending superiorly to the deep spaces of the neck
- extensive subcutaneous emphysema of the anterior chest wall extending to the axillary and scapular regions as well as to the cervicofacial region
- rim of gas around the lung apices indicating small pneumothoraces
- pneumoperitoneum extending from the esophageal hiatus
- No esophageal perforation is seen
Case Discussion
CT features of an iatrogenic tracheal rupture with pneumomediastinum, extensive subcutaneous emphysema, small pneumothoraces, and secondary pneumoperitoneum following tracheal intubation.
Tracheal rupture following endotracheal intubation is considered a rare complication. Many factors may contribute to the tracheal injury such as overinflation of the cuff, trauma following difficult intubation, and anatomical factors 1.
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