Journal of the Korean Society of Laryngology Phoniatrics and Logopedics  2016;27(1):54-57

Severe Complication of Percutaneous Dilatational Tracheostomy.

Young Jin CHO 1 ; Ji Hyung LIM ; Yong Joo LEE ; Inn Chul NAM

Affiliations

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Keywords

Percutaneous dilatational tracheostomy; Complication; Pneumomediastinum; Pneumoperitoneum

Country

Republic of Korea

Language

Korean

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.