A túlfújt endotrachealis mandzsetta szerepe a légcsősérülések diagnosztikájában [The role of an overinflated endotracheal tube in the diagnosis of tracheal injuries]

Rieth, Anna and Ottlakán, Aurél and Kovács, Tamás and Balogh, Brigitta and Furák, József (2020) A túlfújt endotrachealis mandzsetta szerepe a légcsősérülések diagnosztikájában [The role of an overinflated endotracheal tube in the diagnosis of tracheal injuries]. ORVOSI HETILAP, 161 (25). pp. 1063-1068. ISSN 0030-6002

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Abstract

Tracheobronchial injury is an uncommon, but often life-threatening condition. It is mostly caused by blunt thoracic or neck trauma, difficult or prolonged intubation associated with nasogastric tube insertion. An early diagnosis and treatment can be lifesaver. The diagnosis is often late because of atypical symptoms and unspecific radiological signs, and due to the presence of severe coexistent injuries. Generally, the classic hallmark during physical examination is a progressive, extensive surgical emphysema. Radiological signs are often atypical, which makes the diagnosis more difficult. The most frequent signs found on computed tomography are also unspecific, mostly surgical emphysema, pneumomediastinum or pneumothorax may be noted. We present three patients suffering from airway laceration caused by car accident, difficult intubation, and prolonged utilization of nasogastric and endotracheal tube. All the patients had an overdistended endotracheal balloon herniated outside the extratracheal space along the rupture of the tracheal wall. These external balloons were all detected on radiography. This is a direct and pathognomic sign of airway injury, suggesting complete rupture in the tracheal wall. In our report, we would like to highlight the diagnostic role of an overinflated cuff. Orv Hetil. 2020; 161(25): 1063-1068.

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