Delayed Recognition of a Cuff-Level Tracheal Rupture After Double-Lumen Endotracheal Tube Intubation for Thoracic Surgery: A Case Report.
JongHyun Baek, Min Gang Kwon, Eun Kyung Choi
✦ AI-curated · Sources linked
Case in brief
An 81-year-old man underwent left upper lobectomy using a double-lumen endotracheal tube. Postoperatively, he developed persistent air leakage, atelectasis, and subcutaneous emphysema. Bronchoscopy revealed a tracheal wall defect at the cuff level, which was initially missed. After conservative management failed, surgical repair was performed, successfully closing the defect.
What made this case unusual
The tracheal rupture occurred at the cuff level, which initially obscured the injury during bronchoscopic examination, leading to delayed diagnosis.
Diagnostic / clinical pearl
Clinicians should be vigilant for signs of tracheal cuff injuries after double-lumen intubation, especially in the presence of persistent air leaks or subcutaneous emphysema.
Why it matters
This case highlights the importance of early bronchoscopic evaluation in patients with postoperative complications following double-lumen intubation, as cuff-level injuries can be clinically occult.