Life-Threatening Tracheal Diverticulum Rupture Following Laparoscopic Cholecystectomy: A Rare Case Report

Area of Science:

• Medical Case Reports
• Surgical Complications
• Anesthesiology

Background:

• Laparoscopic cholecystectomy is a common surgical procedure.
• Tracheal rupture is a rare but potentially fatal complication of tracheal intubation.
• Tracheal diverticula are uncommon anatomical variations.

Observation:

• A 71-year-old woman developed asystole and hypotension after laparoscopic cholecystectomy.
• Cardiopulmonary resuscitation (CPR) was initiated due to cardiac arrest.
• Subcutaneous emphysema, pneumothorax, and pneumomediastinitis were noted postoperatively, indicating tracheal injury.

Findings:

• Computed tomography revealed a tracheal diverticulum rupture in the distal trachea.
• The rupture was suspected to have occurred during CPR.
• Rapid desufflation of pneumoperitoneum may have contributed to asystole via the Bezold-Jarisch reflex.

Implications:

• Tracheal diverticula can be incidentally discovered and may lead to severe complications if ruptured.
• Tracheal rupture can occur not only from intubation but also from interventions like CPR.
• Prompt diagnosis and surgical intervention are crucial for managing tracheal rupture and ensuring patient recovery.