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Delayed diagnosis of postintubation tracheal laceration in a patient who underwent septorhinoplasty including osteotomy - A case report -
Anesth Pain Med 2018;13(1):102-6
Published online January 31, 2018
© 2018 Korean Society of Anesthesiologists.

Hyo Jung Son1, Sue Jean Mun2, Jin Woo Koh1, Tae Woong Kim1, Hyun-Su Ri3, Hyae-Jin Kim3, Gwi Eun Yeo4, Dong Kyu Lee4, and Yoon Ji Choi3
1Department of Anesthesiology and Pain Medicine, National Police Hospital, Seoul, Departments of 2Otorhinolaryngology and 3Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, 4Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Seoul, Korea
Correspondence to: Yoon Ji Choi, M.D., Ph.D.
Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea
Tel: 82-55-360-2129
Fax: 82-55-360-2149
E-mail: yoonji07@gmail.com
ORCID
http://orcid.org/0000-0003-3031-357X
Received July 11, 2017; Revised September 25, 2017; Accepted October 12, 2017.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Iatrogenic postintubation tracheal injury is a rare but potentially fatal complication associated with anesthesia. However, as signs of tracheal injury including subcutaneous emphysema, pneumomediastinum, pneumothorax, and respiratory distress may also be related to surgical technique, diagnosis may be confused and treatment of tracheal injury can be delayed. We report a case of postintubation tracheal laceration, whose diagnosis was delayed because of symptoms were confused with subcutaneous emphysema after septorhinoplasty including osteotomy. As symptoms deteriorated in spite of conventional management, patient underwent evaluation to determine other causes and eventually postintubation tracheal injury was detected. Therefore, even if there is no problem during tracheal intubation, it is necessary to consider postintubation tracheal injury in patients with subcutaneous emphysema that worsens despite appropriate treatment after septorhinoplasty including osteotomy.
Key Words : Endotracheal intubation, Subcutaneous emphysema, Tracheal laceration.


January 2018, 13 (1)
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