A patient with subcutaneous emphysema following endotracheal intubation.

Difficult intubation can be found in 11% of emergency tracheal intubations.1 Predictors of difficult tracheal intubation have been described, such as mouth opening, Mallampati classification, atlanto-occipital joint extension, mandibulohyoid distance, inter-incisor distance, thyromental distance, sternomental distance, obesity, and a previous history of difficult intubation.2 The occurrence of difficult intubation is associated with morbidity and mortality.1 Here we present an elderly obese patient who developed massive subcutaneous and mediastinal emphysema after difficult emergency intubation.