The tracheal rupture: Delayed diagnosis with endobronchial intubation

Tracheobroncheal rupture is a rare complication of intubation techniques us ing a stylet. In this case report the patient was intubated by an emergency physician in a preclinical setting after a motorvehicle accident. latrogen ic tracheal laceration was masked by inappropriate position of the endobron chial tube. By chance ventilation was maintained to both lungs by flow thro ugh the Murphy's eye of the tube and the lumen of the tube. In correcting t he deep tube position after a chest x-ray laceration of the trachea was unm asked and ventilation problems occurred immediately. The tube was replaced under fiberoptical control and the patient was managed for surgical repair using a jet ventilation technique. In this case two complications of endobr onchial intubation occurred, but the deep tube placement opposed the effect s of the tracheal laceration. This was probably life saving for the patient during emergency transfer by helicopter after the accident. The anaesthesi ological management during tracheal repair is discussed.