Major Tracheal Injury with Head and Neck Emphysema Complicating Intubation in Elective Surgery: Diagnostic Aspects and Management in a Resource-Limited Setting

Tracheal intubation complications in emergency circumstances are well known and may be serious. A 15 year-old girl underwent Killian tumour resection developed subcutaneous emphysema on extubation causing severe respiratory failure that required an emergency tracheotomy with insertion of the endotracheal tube. Emergency head and chest radiography performed in the operating room showed diffuse gaseous infiltration of the paraspinal soft tissues of the cervical region. Bronchoscopy performed on postoperative day 1 showed tracheal injury. Endotracheal tube was removed successfully on postoperative day 3 and the patient was discharged from the hospital. Otorhinolaryngology follow-up examination on postoperative day 7 was unremarkable.