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Subcutaneous emphysema and pneumomediastinum complicating endotracheal intubation--a case report

O A Soyannwo1, O A Ogunseyinde

  • 1Department of Anaesthesia, University College Hospital, Ibadan, Nigeria.

African Journal of Medicine and Medical Sciences
|September 1, 1987
PubMed

Insights

A rare case of subcutaneous emphysema and pneumomediastinum occurred in an infant after tracheal intubation. This condition resulted from external pressure during the procedure, highlighting potential risks.

Area of Science:

  • Pediatric Medicine
  • Anesthesiology
  • Emergency Medicine

Background:

  • Tracheal intubation is a common procedure in pediatric critical care.
  • Complications, though rare, can arise from airway manipulation.
  • Subcutaneous emphysema and pneumomediastinum are potential, albeit infrequent, sequelae.

Observation:

  • A 5-month-old infant developed subcutaneous emphysema and pneumomediastinum.
  • This complication followed tracheal intubation using a non-kinkable tube with an in-situ stylet.
  • External pressure applied to the trachea during intubation was implicated.

Findings:

  • The case highlights a potential iatrogenic cause of pneumomediastinum and subcutaneous emphysema in infants.
  • The use of a stylet in a non-kinkable tube during intubation may increase the risk of airway injury.
  • External pressure on the trachea during the procedure is a critical factor.

Implications:

  • Awareness of this complication is crucial for pediatric intensivists and anesthesiologists.
  • Careful technique and consideration of airway anatomy are essential during infant intubation.
  • Prompt recognition and management strategies for these rare complications should be established.

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