Tracheal rupture complicating emergent endotracheal intubation

Tracheal rupture is rare in clinical practice. We present 2 female patients with tracheal rupture after emergent endotracheal intubation from different injury mechanisms; penetrating injury of using stylet during intubation in one case and overinflation of cuff of the endotracheal tube under rapid sequence intubation in another. The lesions of rupture could be detected by bronchoscopy and reconstructive 3-dimensional computed tomography. Both cases received surgical repair without complication. In our report, reconstructive 3-dimensional computed tomography scrupulously detected the rupture sites and provided the noninvasive modality for diagnosis. We review the literature of tracheal rupture after emergent endotracheal intubation in respects of the diagnosis, the possible mechanisms of the injury, and suggest strategies of management.