Zaki Hany A, Zahran Adel, Elsafti Elsaeidy Abdallah M, Shaban Ahmed E, Shaban Eman E
Emergency Medicine, Hamad Medical Corporation, Doha, QAT.
Internal Medicine, Mansoura General Hospital, Mansoura, EGY.
Cureus. 2021 Dec 27;13(12):e20762. doi: 10.7759/cureus.20762. eCollection 2021 Dec.
A tracheostomy tube (TT) is usually taken out in a well-planned and coordinated manner after the underlying condition that necessitated the procedure is resolved. The inadvertent removal or dislodgement of the TT from the stroma is known as accidental extubation or decannulation. This event may prove fatal in a stable patient. Like other respiratory procedures, tracheostomy with the long-term placement of tracheal tube comes with several risks, including scarring of the trachea, pneumothorax, tracheal rupture, and tracheoesophageal fistula. Other complications may include pneumomediastinum (PM) or the escape of air into the surrounding tissue. This may be attributed to several reasons, including mispositioning of the tracheal tube, barotrauma, or tracheal rupture. In some cases, PM presents with free air into cavities such as the thorax, peritoneum, or subcutaneous tissue. Although not fatal, it may require complex treatments such as ventilator management, high-flow oxygen, or, in some cases, surgical intervention. In this article, we describe a rare case of PM and generalized surgical emphysema due to mispositioning of the tracheal tube.
气管造口管（TT）通常在导致该手术的潜在病情得到解决后，以精心规划和协调的方式取出。TT从气管造口处意外拔出或移位被称为意外拔管或脱管。这一事件在病情稳定的患者中可能是致命的。与其他呼吸手术一样，长期放置气管导管的气管造口术存在多种风险，包括气管瘢痕形成、气胸、气管破裂和气管食管瘘。其他并发症可能包括纵隔气肿（PM）或空气逸入周围组织。这可能归因于多种原因，包括气管导管位置不当、气压伤或气管破裂。在某些情况下，PM表现为空气进入胸腔、腹膜或皮下组织等腔隙。虽然不致命，但可能需要复杂的治疗，如呼吸机管理、高流量吸氧，或在某些情况下进行手术干预。在本文中，我们描述了一例因气管导管位置不当导致的罕见的PM和全身性手术性气肿病例。
