Airway Management of a Patient with Esophago-tracheal Perforation by Endotracheal Tube: A case report / 대한마취과학회지

ABSTRACT

Although uncommon and rarely reported, tracheo-esophageal perforation during traumatic intubation is life threatening and associated with a high mortality rate. It may result in severe airway complications such as a pneumothorax, pneumomediastium, pneumonia, and mediastinitis. The mortality rate of esophageal perforation has been reported to range from 6 to 34%, and up to 56% if the diagnosis is delayed by more than 12 hours after the event. In our case, the patient had been intubated for 3 weeks with an esophago-tracheal perforation. The perforation was not found by the physician because he had no signs of esophageal perforation, the tip of endotracheal tube was well in the trachea and balloon of the tube was sufficient to prevent air leakage. After the failure of extubation for three times, the diagnosis was carried out by gastrofibroscopy, bronchoscopy and chest 3-dimensional computed tomography. His tracheal and esophageal walls were injured with severe inflammation. Therefore, primary repair could not be done and only a tracheostomy was performed.