RESUMO
Las laceraciones traqueobronquiales traumáticas postintubación son una complicación clínica poco frecuente en la práctica diaria. Se han relacionado con intentos repetitivos de intubación e hiperinsuflación del balón, así como con alteraciones anatómicas y factores individuales que puedan predisponerla. El diagnóstico se obtiene, actualmente, mediante la endoscopia respiratoria, ya que informa sobre su localización y la extensión lesional. Presentamos el caso de una paciente con laceración de la cara posterior traqueal secundaria a intubación endotraqueal que comenzó con enfisema mediastínico subcutáneo y neumotórax bilateral en el postoperatorio inmediato. El diagnóstico se realizó mediante fibrobroncoscopia y tomografía computarizada y requirió cirugía traqueal de urgencia (AU)
Tracheobronchial rupture after tracheal intubation is rare in clinical practice. Possible contributory factors are multiple vigorous attempts at intubation, overinflation of the cuff, anatomic alterations, and predisposing individual factors. These lesions can be detected by bronchoscopy, which is the most effec-tive method to confirm the diagnosis and determine the exact location and extent of the tear. We report the case of a woman with membranous tracheal rupture after endotracheal intubation. Subcutaneous emphysema, pneumomediastinum and bilateral pneumothorax were noted after extubation. The diagnosis was confirmed by fiberoptic bronchoscopy and computed tomography scan, and the patient required emergency surgical repair (AU)
Assuntos
Feminino , Pessoa de Meia-Idade , Humanos , Intubação/métodos , Intubação Intratraqueal/métodos , Doença Iatrogênica , Lacerações/complicações , Lacerações/cirurgia , Enfisema Mediastínico/complicações , Enfisema Mediastínico/diagnóstico , Enfisema Mediastínico/cirurgia , Fístula/terapia , Fístula do Sistema Respiratório/terapia , Intubação Intratraqueal , Broncoscopia , Tomografia Computadorizada de Emissão , Perda Auditiva/complicações , Pneumotórax/cirurgia , Traqueia/patologia , Traqueia/cirurgia , Traqueia , Neoplasias da Traqueia/cirurgia , Neoplasias da TraqueiaRESUMO
Tracheobronchial rupture after tracheal intubation is rare in clinical practice. Possible contributory factors are multiple vigorous attempts at intubation, overinflation of the cuff, anatomic alterations, and predisposing individual factors. These lesions can be detected by bronchoscopy, which is the most effective method to confirm the diagnosis and determine the exact location and extent of the tear. We report the case of a woman with membranous tracheal rupture after endotracheal intubation. Subcutaneous emphysema, pneumomediastinum and bilateral pneumothorax were noted after extubation. The diagnosis was confirmed by fiberoptic bronchoscopy and computed tomography scan, and the patient required emergency surgical repair.
