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[Dyspnoea after complication-free tracheostomy].

S Horster¹, H J Stemmler, S Geiger

¹Medizinische Klinik und Poliklinik II, Ludwig-Maximilians-Universität - Campus Großhadern, München.

Deutsche Medizinische Wochenschrift (1946)

|March 15, 2012

Summary

A tracheostomy complication was identified: an intratracheal blood clot caused airway obstruction. Prompt bronchoscopy is crucial for diagnosing such rare but serious airway issues in tracheostomy patients.

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Area of Science:

Pulmonology
Critical Care Medicine
Otolaryngology

Background:

A 70-year-old woman with metastatic breast cancer developed progressive vocal cord paresis, necessitating a tracheostomy.
Following tracheostomy, the patient experienced worsening dyspnea and respiratory distress, unresponsive to cannula maintenance.

Observation:

Fiberoptic bronchoscopy revealed a black foreign body distal to the tracheal cannula.
Removal of the cannula led to the expulsion of a large blood clot.
Subsequent bronchoscopy showed a tracheal wall ulcer at the cannula's prior position.

Findings:

The patient's symptoms were caused by an intratracheal blood clot, a rare complication of tracheostomy.
The blood clot likely formed due to irritation and ulceration of the tracheal wall by the cannula.

Implications:

Intratracheal thrombi can be a cause of obstructive symptoms after tracheostomy.
Endoscopic evaluation is essential for patients presenting with new obstructive symptoms post-tracheostomy.
This case highlights the importance of considering uncommon complications in airway management.