A fatal complication of tracheostomy cannula exchange: Bilateral pneumothorax, pneumomediastinum, and subcutaneous emphysema

Year 2024, , 71 - 73, 22.09.2024

Fatih Çatal

https://doi.org/10.33706/jemcr.1519281

Abstract

Introduction: Although tracheostomy opening or replacement is generally a safe procedure, it carries varying risks of complications. Serious complications include false lumen formation between tissues surrounding the trachea, tracheal posterior wall damage, bleeding, pneumomediastinum, pneumothorax, and death. The incidence of these complications increases especially in patients who are obese, have a short neck or anatomical deformity.
Case Report: A 24-year-old male patient was brought to the emergency department with respiratory distress. His family stated that his complaints started four days ago after the change of the tracheostomy cannula in a hospital. Computed tomography of the neck and chest revealed subcutaneous emphysema in the neck and anterior chest, free air between deep tissues in the neck, pneumomediastinum and bilateral pneumothorax. Supportive oxygen therapy was started and the patient was consulted for thoracic surgery. After tube thoracostomy of the right hemithorax, intensive care unit hospitalization was performed. The patient died on the 25th day of intensive care unit hospitalization due to type 2 respiratory failure.
Conclusion: In patients with tracheostomy presenting to the emergency department with dyspnea, cannula-related causes should also be considered in the differential diagnosis.

Keywords

Bilateral pneumothorax, Tracheostomy, Complication, Subcutaneous emphysema, Pneumomediastinum

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