J Korean Soc Laryngol Phoniatr Logoped.  2016 Jun;27(1):54-57. 10.0000/jkslpl.2016.17.1.54.

Severe Complication of Percutaneous Dilatational Tracheostomy

Affiliations
  • 1Department of Otolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. entnam@catholic.ac.kr

Abstract

Percutaneous dilatational tracheostomy (PDT) has become an increasingly popular method of establishing an airway for patients in need of chronic ventilator assistance. We report a rare case of a 42-year-old female who developed extensive subcutaneous emphysema, bilateral pneumothoraces, pneumomediastinum, and pneumoperitoneum after percutaneous dilatational tracheostomy. The patient suffered from amyotrophic lateral sclerosis, and underwent PDT after a period of mechanical ventilation. During PDT, tracheostomy tube was inserted into the paratracheal space. Follow-up chest radiography and computed tomography of chest and abdomen revealed extensive subcutaneous emphysema, bilateral pneumothoraces, pneumomediastinum, and pneumoperitoneum. The patient was treated successfully with insertion of the thoracostomy tube and conservative care.

Keyword

Percutaneous dilatational tracheostomy; Complication; Pneumomediastinum; Pneumoperitoneum

MeSH Terms

Abdomen
Adult
Amyotrophic Lateral Sclerosis
Female
Follow-Up Studies
Humans
Mediastinal Emphysema
Methods
Pneumoperitoneum
Radiography
Respiration, Artificial
Subcutaneous Emphysema
Thoracostomy
Thorax
Tracheostomy*
Ventilators, Mechanical
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