[Rare complications following tracheotomy and intubation (author's transl)]

Report on two cases: Case 1: A young male was tracheotomized because of respiratory insufficiency due to a thoraco-abdominal trauma. The injuries were fatal 8 hours following tracheotomy. Autopsy revealed a tube like formation located in the upper trachea, consisting of coagulated blood. The peculiar shape was caused by a splinting effect of the tracheal cannula. A trickling tracheostomal hemorrhage was found to be the causal factor. --Case 2: After long-term tracheotomy due to a laryngeal trauma a tracheostomal intubation was performed in a young male for the purpose of a surgical revision of the laryngeal injuries. Two days later sudden death occurred. Autopsy revealed a tube like formation in the upper trachea, consisting of fibrin and desquamated necrotic tracheal epithelium, which had occluded the cannula in a valve like manner. The originating mechanism of this pathological state is demonstrated. The significance of preexisting chronic tracheitis and the use of a tube with a rather rigid cuff (nylon spiral tube) as additional promoting factors are discussed.