Posterior tracheal wall disruption: a rare complication of pediatric tracheotomy and bronchoscopy.

Disruption of the posterior tracheal wall is an uncommon complication of tracheotomy, bronchoscopy, or even endotracheal intubation. With disruption of the posterior tracheal wall, air tracking may present as surgical emphysema, pneumomediastinum, or pneumothoraces, and may be associated with respiratory distress. Six children with posterior tracheal wall disruptions are presented: three associated with tracheotomy, one bronchoscopy, and another during endotracheal intubation. Early recognition and appropriate management of tracheal disruption will minimize air tracking and the associated morbidity. Tracheal disruption may be avoided by utilizing appropriate surgical, endoscopic, and intubation techniques.