Tracheal Stenosis Identified With Bronchoscopy Nine Years After Emergent Short-Term Intubation

Tracheal stenosis is an uncommon but life-threatening complication of endotracheal intubation. The prevalence of tracheal stenosis after long-term intubation is 19%; however, only 1-2% of patients are symptomatic. Common risk factors include a history of previous intubation, duration of intubation, difficult airway, traumatic intubation, prior tracheostomy, advanced age, female sex, estrogen use, severe respiratory failure, and severe gastroesophageal reflux disease, among others. The typical presentation of tracheal stenosis is gradual dyspnea and wheezing that is unresponsive to bronchodilators and steroids. We describe a case of a 33-year-old female patient with atypical presentation who was diagnosed with tracheal stenosis on bronchoscopy nine years following initial short-term endotracheal intubation. Clinicians should maintain a high index of suspicion for tracheal stenosis and a low threshold to perform fiberoptic bronchoscopy in patients with persistent respiratory symptoms after a history of endotracheal intubation, to avoid delays in diagnosis and treatment.