Tracheal rupture as a result of coughing

Tracheal rupture is mostly traumatic or iatrogenic. A few cases of spontaneous tracheal rupture have been reported in literatüre and all of them have been described posterior membraneous wall which is the weakest portion of trachea. In most of such cases, predisposing factors that weaken the tracheal structure were present. We presented the first case of spontaneous anterolateral tracheal rupture as a result of coughing that caused no respiratory distress and that spontaneously recovered without any complications. A 24 year old male presented to the emergency department with sore throat. After eating chicken shawarma, the patient felt a lump in his throat and coughed. After coughing, a tearing like and severe pain developed at his neck's front region radiating to his shoulders and back. On past medical history, the patient had no known diseases and had no history of use of medications. Physical examination findings were unremarkable except for neck tenderness. Pneumomediastinum, free air within the cervical fascias and a 4mm tracheal mural defect on the left anterolateral side at the level superior to the manubrium was observed in computerised tomography scan of neck and chest. The patient had no shortness of breath and therefore urgent surgery was not considered. Increase in free air was not seen in the control x-rays 6 hours later. The patient with a foriegn nationality left the emergency at his own will. He was contacted one month later via telephone. The patient said that his neck pain subsided and had no other complaints.