Chakma Avishek, Siddiqui Obaid Ahmed, Ali Shahna, Nadeem Abu
Resident, Jawaharlal Nehru Medical College, Aligarh, India.
Associate Professor, Jawaharlal Nehru Medical College, Aligarh, India.
Med J Armed Forces India. 2023 Jul-Aug;79(4):481-484. doi: 10.1016/j.mjafi.2021.08.014. Epub 2021 Oct 7.
Tracheostomy is a common airway procedure for life support in critically ill patients with head injuries. This procedure is safe but also associated with early and late complications. Tube fracture and dislodgement into the tracheobronchial tree leading to airway obstruction is a rare but life-threatening complication after prolonged tracheostomy tube placement. There are very few published reports of tracheostomy tube fracture and dislodgement into tracheobronchial tree in a neurologically injured patient. We report a case of a fractured tracheostomy tube which got impacted in the left main bronchus, in a 41-year-old male patient who had been on prolonged tracheostomy tube after craniotomy and evacuation of subdural hematoma. The distal part of the tracheostomy tube fractured and impacted in the left main bronchus. Fibreoptic bronchoscopy was performed through the oral cavity to extract it, and the anaesthetic management during the period is discussed.
气管切开术是颅脑损伤重症患者维持生命的常见气道操作。该操作安全，但也会伴有早期和晚期并发症。气管切开导管断裂并进入气管支气管树导致气道阻塞是长期放置气管切开导管后罕见但危及生命的并发症。关于神经损伤患者气管切开导管断裂并进入气管支气管树的报道非常少。我们报告了一例41岁男性患者的病例，该患者在开颅手术清除硬膜下血肿后长期使用气管切开导管，其气管切开导管断裂并卡在左主支气管中。气管切开导管的远端断裂并卡在左主支气管中。通过口腔进行了纤维支气管镜检查以取出导管，并讨论了在此期间的麻醉管理。
