successful conservative management of tracheal injury after forceful coughing during extubation: a case report

a-56-year-old woman underwent carpal tunnel release surgery under general anesthesia. thirty minutes after extubation, the patient complained of chest discomfort with dyspnea. swelling of the neck and upper anterior chest was observed. computed tomography of the chest showed tracheal rupture at the brachiocephalic trunk level, and bronchoscopy demonstrated a 5 cm linear tracheal defect in the posterior membranous wall, 6 cm proximal to the carina. surgical repair of the tracheal injury was impossible due to its location. the patient was managed with intubation, mechanical ventilator care, and antibiotics. she made a full and uncomplicated recovery and was discharged 18 days after the original injury. when suspicious symptoms appear in patients receiving mechanical ventilation support, an immediate and accurate diagnostic process should be undertaken to rule out endotracheal tube-related tracheal injuries and to avoid potentially lethal complications.