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气管切开术导致气管破裂引起的气腹:一例报告

Pneumoperitoneum caused by tracheal rupture due to tracheotomy: a case report.

作者信息

Wang Herong, Li Xue, Shi Lixia, Guo Chunxu, Yu Hongzhi, Wang Xing, Zhou Jing, Zhang Shuo, Xing Zhiheng, Cui Chao, Yang Wanjie, Li Li

机构信息

Department of Respiratory and Critical Care, Haihe Hospital, Tianjin University, Tianjin, 300350, China.

Tianjin Institute of Respiratory Diseases, Tianjin, 300350, China.

出版信息

BMC Pulm Med. 2025 May 16;25(1):237. doi: 10.1186/s12890-025-03653-6.

Abstract

BACKGROUND

Tracheal rupture is a rare but serious complication associated with tracheal intubation, often presenting with clinical manifestations such as subcutaneous emphysema, mediastinal emphysema, and pneumothorax. Pneumoperitoneum after tracheal intubation is an unusual occurrence. Treatment strategies typically include surgical intervention and conservative management. This article presents a case of tracheal rupture following tracheal intubation that led to massive pneumoperitoneum and was successfully managed with conservative treatment.

CASE PRESENTATION

A patient underwent tracheal intubation, during which a tracheal rupture occurred, leading to significant pneumoperitoneum. The condition was initially diagnosed based on clinical symptoms, including abdominal distension and imaging results. Conservative treatment, including respiratory support and monitoring, was implemented. Follow-up abdominal CT on day 6 demonstrated resolution of the pneumoperitoneum, and repeat bronchoscopy on day 10 confirmed healing of the tracheal laceration.

CONCLUSION

Tracheal rupture and subsequent pneumoperitoneum should be considered as differential diagnoses in patients presenting with abdominal distension following tracheal intubation. Prompt diagnosis and appropriate conservative management can lead to favorable outcomes.

摘要

背景

气管破裂是气管插管相关的一种罕见但严重的并发症,常表现为皮下气肿、纵隔气肿和气胸等临床表现。气管插管后出现气腹是一种不常见的情况。治疗策略通常包括手术干预和保守治疗。本文介绍了一例气管插管后发生气管破裂并导致大量气腹,经保守治疗成功治愈的病例。

病例介绍

一名患者接受气管插管,在此过程中发生气管破裂,导致大量气腹。该病情最初根据临床症状(包括腹胀)和影像学结果进行诊断。实施了包括呼吸支持和监测在内的保守治疗。第6天的腹部CT随访显示气腹消失,第10天重复支气管镜检查证实气管裂伤愈合。

结论

对于气管插管后出现腹胀的患者,应将气管破裂及随后的气腹视为鉴别诊断。及时诊断和适当的保守治疗可带来良好的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58f3/12084994/5642e767cb7e/12890_2025_3653_Fig1_HTML.jpg

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