Post-intubation iatrogenic tracheobronchial injuries: The state of art

[Tracheobronchial Injuries]

Tracheobronchial injury is a rare, but potentially life-threatening condition. These injuries are associated with high morbidity and mortality, which is ascribed to underlying diseases and additional injuries. Lacerations of the airway are differentiated into iatrogenic and non-iatrogenic injuries, while the group of non-iatrogenic lesions are grouped into blunt and penetrating traumas.The exact incidence of tracheobronchial injury is unknown, because many iatrogenic injuries occur without symptoms and most patients after traumatic laceration die before inpatient treatment. All patients with suspicion of airway injury require fast and accurate management.Common signs and symptoms are dyspnoea, haemoptysis, stridor and subcutaneous emphysema.Bronchoscopy is the most important tool for diagnosis and in several cases also for initial treatment.Further management depends on the patient's clinical condition and findings of bronchoscopy and computed tomography. Surgery has been the cornerstone of therapy, but in selected patients bronchoscopic stent implantation or conservative management must be discussed.

Anesthetic Management of Iatrogenic Tracheal Injury: A Case Report

Tracheal perforation following oesophagectomy is a very rare and occasionally life-threatening condition that requires a high degree of suspicion and early intervention for optimal patient outcomes. This article presents a case report of a 46-year-old male who presented with respiratory failure secondary to tracheal perforation at the level of carina following a two-stage oesophagectomy. He underwent a second emergency procedure; the airway was secured with a left-sided double-lumen tube, and tracheal perforation was successfully repaired. This case report will briefly cover the challenges and difficulties faced by anesthetists in the airway management, ventilation, and hemodynamic instability of such patients.