Tracheal Erosion Secondary to Prolonged Endotracheal Intubation in a Patient With Bilateral Cerebellar Stroke: A Case Report.

Tracheal erosion is a rare but life-threatening complication of prolonged endotracheal intubation, especially in medically complex patients. We report a case of a 70-year-old male with multiple comorbidities, including bilateral cerebellar stroke, multi-infarct dementia, and heart failure with reduced ejection fraction, who developed tracheal erosion secondary to prolonged endotracheal intubation of 265 days. Computed tomography revealed that the endotracheal tube had pierced the anterior wall of the trachea. Due to extensive tracheal erosion and the patient's poor surgical candidacy, tracheostomy was not feasible. The patient was managed conservatively under multidisciplinary care. This case highlights the diagnostic and management challenges of a tracheal injury in critically ill patients and reinforces the importance of early airway intervention, close tube monitoring, and individualized management strategies.