Edorium Journal of

Anesthesia

 
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Case Report
 
Severe tracheal stenosis after short-term endotracheal intubation: A case report
Tatjana Goranović1, Zoka Milan2, Irena Pirkl3, Višnja Nesek Adam4
1MD, PhD, Senior Teaching Assistant, Consultant Anesthetist and Intensivist, Department of Anesthesiology, Reanimatology and Intensive Care Medicine, University Department for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; Senior Teaching Assistant, Faculty of Medicine, University of Osijek, Croatia.
2MD, PhD, Honorary Senior Lecturer, Visiting Professor, Consultant Anesthetist and Intensivist, Honorary Senior Lecturer, Visiting Professor, Anesthetic Department, King's College Hospital, London, United Kingdom.
3MD, Consultant Otorhinolaryngologist, Department of Otorhinolaryngology and Head and Neck Surgery, Sveti Duh University Hospital, Zagreb, Croatia.
4MD, PhD, Assistant Professor, Consultant Anesthetist and Intensivist, Head of University Department of Anesthesiology, Reanimatology and Intensive Care Medicine, Sveti Duh University Hospital, Zagreb, Croatia; Assistant Professor, Faculty of Medicine, University of Osijek, Croatia.

Article ID: 100007A05TG2016
doi:10.5348/A05-2016-7-CR-3

Address correspondence to:
Tatjana Goranović
Department of Anesthesiology, Reanimatology and Intensive Care Medicine
University Department for Tumours, Sestre milosrdnice University Hospital Centre
Ilica 197, 10000 Zagreb
Croatia

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How to cite this article
Goranovic T, Milan Z, Pirkl I, Nesek Adam V. Severe tracheal stenosis after short-term endotracheal intubation: A case report. Edorium J Anesth 2016;2:10–13.


Abstract
Introduction: Prolonged endotracheal intubation is a risk factor for the development of tracheal stenosis. The incidence of stenosis is very low if intubation lasts less than a week and patients may be asymptomatic for a long time.
Case Report: We present a case of an 86-year-old female who developed severe tracheal stenosis after short-term endotracheal intubation, with her first hospital admission for stridor only two weeks after the intubation. One month after the intubation computed tomography (CT) scan revealed an 18-mm long tracheal stenosis at the level of the thyroid gland, 1 cm below the glottis, with 3 mm of free tracheal lumen at the narrowest part. During CT scan, the patient rapidly became dyspnoeic, cyanotic, and agitated. An urgent tracheostomy was performed under local anesthesia with the patient in a semi-sitting position. When ventilation through this tube was possible, the patient was anesthetised, repositioned in the supine position and a permanent tracheostomy was performed.
Conclusion: An atypical medical history delayed the diagnosis and treatment, which would have been different if the appropriate diagnosis had been made earlier. Presentation with symptoms of airway obstruction and a history of mechanical intubation, no matter how short and recent, requires detailed history taking, careful examination and diagnostic approach to make the diagnosis of tracheal stenosis in a timely manner and treat it adequately.

Keywords: Endotracheal intubation, Mechanical ventilation, Stridor, Tracheal stenosis, Treatment


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Author Contributions
Tatjana Goranović – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Zoka Milan – Substantial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Irena Pirkl – Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Višnja Nesek Adam – Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Tatjana Goranović et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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