[Emergency Surgery for Iatrogenic Injury to the Trachea During Emergency Tracheal Intubation]

An 86-year-old woman lost consciousness at home. Tracheal intubation was performed in the ambulance during transport to our hospital. Computed tomography (CT) showed right putaminal hemorrhage in her brain, right pneumothorax, and mediastinal emphysema. The patient underwent craniotomy after chest tube drainage. However, the subcutaneous emphysema worsened postoperatively. Chest CT revealed a 2 cm tracheal injury on the cranial side of the tracheal bifurcation. Since iatrogenic injury of the trachea by intubation was suspected, the patient underwent emergency surgery. A 4 cm longitudinal laceration was visible in the membranous portion of the trachea. Continuous suture using 4-0 polydioxanone was performed and the suture site was covered with thymic fat. Postoperative bronchoscopy revealed only a scar at the repair site. Tracheal intubation is a common routine medical procedure, but avoidance of tracheal injury requires close attention. In this case, early surgery achieved good results.