Tracheal Cartilage Fracture: A Rare Cause of Weaning Failure

A 42-year-old female developed a rare complication of tracheal ring fracture following repeated percutaneous dilatational tracheostomy, which was performed after intubation due to progressive respiratory failure in the case of treated organophosphate poisoning. The patient first presented with organophosphate poisoning and was intubated in view of altered sensorium and tracheostomized after a prolonged stay in the intensive care unit. The patient was successfully weaned off and the tracheostomy tube was removed; the patient had progressive breathlessness over the duration of five months and presented with stridor, requiring emergency intubation and repeat tracheostomy due to respiratory failure. Imaging studies showed bilateral pleural effusion, right middle lobe consolidation, and scattered ground glass opacities. The patient received intravenous antibiotics and fluid therapy but faced challenges with weaning despite meeting the criteria. Bronchoscopy revealed a broken tracheal cartilage obstructing the tube, which was removed, leading to improved respiratory status and successful weaning off the ventilator. The patient underwent tracheal wall repair, was decannulated, and discharged successfully following extubation.