J Korean Med Sci.  2010 Sep;25(9):1384-1386. 10.3346/jkms.2010.25.9.1384.

Obstructive Fibrinous Tracheal Pseudomembrane After Tracheal Intubation: A Case Report

• Kang HH
• Kim JW
• Kang JY
• Kim JS
• Kim MS
• Kim SS
• Kim YH
• Lee SH
• Moon HS

• KMID: 1785923
• DOI: http://doi.org/10.3346/jkms.2010.25.9.1384

Abstract

Obstructive fibrinous tracheal pseudomembrane is a rare, but potentially fatal complication associated with endotracheal intubation. It has been known that the formation of tracheal pseudomembrane is related with intracuff pressure during endotracheal intubation or infectious cause. But in the patient described in this case, pseudomembrane formation in the trachea was associated with subglottic epithelial trauma or caustic injuries to the trachea caused by aspirated gastric contents during intubation rather than tracheal ischemia due to high cuff pressure. We report a patient with obstructive fibrinous tracheal pseudomembrane after endotracheal intubation who presented with dyspnea and stridor and was treated successfully with mechanical removal using rigid bronchoscopy.

Keyword

Airway Obstruction; Intubation; Bronchoscopy

MeSH Terms

Aged
Airway Obstruction/*etiology/surgery
Bronchoscopy
Female
Humans
Intubation, Intratracheal/*adverse effects
Tomography, X-Ray Computed
Tracheal Diseases/*diagnosis/etiology/surgery

Figure

• 

  Fig. 1 Chest computed tomography image at the level of the trachea just below the vocal cords showing luminal narrowing.

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  Fig. 2 Bronchoscopic image showing a thick, annular, rubberlike pseudomembrane encircling the tracheal wall.

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  Fig. 3 Gross view of the pseudomembrane removed at rigid bronchoscopy.

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  Fig. 4 Microscopic examination showing that the pseudomembrane consists of fibrinous material with polymorphonulclear cell infiltration (H&E stain ×100).

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