Multidisciplinary Assessment and Successful Conservative Management of Post-Intubation Tracheal Rupture - Abstract
Background: Tracheal rupture is a fearsome complication that can occur after single-lumen, double-lumen intubation, percutaneous tracheostomy, or surgical tracheostomy. Mortality rate is high, and it is difficult to quantify the real number due to the unknown amount of procedures performed worldwide. Timing is critical. It is important to decide to follow a conservative or a surgical approach based on the type of rupture, clinical symptoms and radiological findings. Case Description: We describe the case of a 52-year-old woman with tracheal rupture diagnosed after intubation for reduction mastectomy. The patient came to our attention with regular vital parameters and clinically without symptoms with a tracheal lesion on the chest CT scan. After a multidisciplinary evaluation including Interventional Pneumologist, Intensive Care Unit and Thoracic Surgery, in view of the clinical radiological picture, it was decided to followup the patient with radiological imaging and bronchoscopies. A surgical approach was not chosen, considering location, size of the lesion and clinical conditions. The patient after eleven days was discharged in good clinical conditions. Conclusions: Treatment of tracheal tears is variable. This is a life-threatening condition, and a multidisciplinary evaluation is at the basis of the proper treatment. Although location and timely diagnosis are crucial, not all tracheal tears are to be treated surgically; conservative treatment is often crucial.