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Tracheal rupture following cervical manipulation: late complication posttracheostomy
Archives of Physical Medicine and Rehabilitation
|January 1, 1986
Summary
Forceful neck manipulation can cause tracheal rupture in patients with prior tracheostomy scars. This case highlights the risks associated with cervical manipulation on weakened tracheal tissues, emphasizing the need for caution.
Area of Science:
- Medicine
- Surgery
- Pulmonology
Background:
- Tracheal rupture is a rare but serious complication.
- Patients with a history of tracheostomy may have weakened tracheal tissues.
- Forceful cervical manipulation is a potential trigger for such injuries.
Observation:
- A patient with a 25-year-old healed tracheostomy experienced tracheal rupture after cervical manipulation.
- Symptoms included recurrent abscesses and tracheocutaneous fistulas.
- Xerography demonstrated abscess cavity ballooning during the Valsalva maneuver.
Findings:
- The manipulation likely caused an anterior tracheal wall tear.
- The condition was treated with oral antibiotics and surgical intervention.
- Complete symptom resolution was achieved post-surgery.
Implications:
- This is the first documented case of tracheal rupture secondary to cervical manipulation in a post-tracheostomy patient.
- Post-tracheostomy scar tissue is identified as a vulnerable site.
- Reinforces cervical manipulation as a contraindication in patients with a history of tracheostomy.