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断裂的金属气管切开插管作为左主支气管内的罕见异物:一例报告

Fractured Metallic Tracheostomy Tube as an Unusual Foreign Body in The Left Main Bronchus: A Case Report.

作者信息

Fityani Mohammad, Juma Yazan, Omari Mohammed, Tayyem Imad, Sweity Raghad, Deeb Maher, Abu Asbeh Yousef

机构信息

Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.

St. Joseph Hospital, Jerusalem, Palestine.

出版信息

Clin Med Insights Case Rep. 2025 Jun 14;18:11795476251346991. doi: 10.1177/11795476251346991. eCollection 2025.

Abstract

INTRODUCTION

Tracheostomy is a vital airway procedure for critically ill patients with acute respiratory failure. This study presents a rare but serious complication: the fracture and migration of a tracheostomy tube into the tracheobronchial tree, and discusses its management.

CASE PRESENTATION

A 43-year-old male, with a tracheostomy tube in place for 8 years following a neck blast injury, presented with a foreign body in his airway. Chest X-ray revealed a fractured metallic tracheostomy tube lodged in the left main bronchus. The tube was successfully removed by rigid bronchoscopy under general anesthesia, and the patient was discharged in good condition with a new tracheostomy tube.

DISCUSSION

Tracheostomy tubes, typically made of polyvinyl chloride or metal, can fracture due to prolonged use without regular check-ups, or replacement. Patients may present with mild respiratory symptoms or be asymptomatic. Diagnosis is confirmed by X-ray, and removal is performed via rigid bronchoscopy.

CONCLUSION

Fractured tracheostomy tubes are a rare but potentially fatal complication requiring urgent bronchoscopy. Regular follow-up, proper care, timely tube replacement, and patient education are essential to prevent such occurrences.

摘要

引言

气管切开术是治疗急性呼吸衰竭重症患者的一项重要气道手术。本研究介绍了一种罕见但严重的并发症:气管切开套管断裂并移入气管支气管树,并讨论了其处理方法。

病例介绍

一名43岁男性,在颈部爆炸伤后气管切开置管8年,因气道内有异物就诊。胸部X线显示一枚断裂的金属气管切开套管嵌顿于左主支气管。在全身麻醉下通过硬质支气管镜成功取出套管,患者带着新的气管切开套管状况良好地出院。

讨论

气管切开套管通常由聚氯乙烯或金属制成,由于长期使用而未定期检查或更换可能会断裂。患者可能出现轻微呼吸道症状或无症状。通过X线确诊,通过硬质支气管镜取出。

结论

气管切开套管断裂是一种罕见但可能致命的并发症,需要紧急进行支气管镜检查。定期随访、妥善护理、及时更换套管以及对患者进行教育对于预防此类情况至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42e9/12171248/ed90eaa1b6a6/10.1177_11795476251346991-fig1.jpg

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