Aspiration of a fractured tracheostomy tube, a rare complication of tracheotomy: the factors involved in this incident and literature review
Keywords:Inhalation, Tracheostomy tube inhalation, Complication of tracheostomy, Foreign body
Tracheostomy is executed routinely for several indications. It is a safe and life-saving procedure. In some cases, the tracheostomy tube has to be maintained for a long duration. We report a rare case of aspiration of a fractured tracheostomy tube. In the light of the literature, we reported the various factors leading to complications of tracheotomy. A 5-year-old boy, presenting to the emergency department for aspiration of a fractured tracheostomy tube accidentally during a cleaning process by his mother. On clinical examination, the patient was slightly symptomatic. A flexible bronchoscopy was made which objectified the presence of the cannula in the trachea, an additional chest X-ray was taken, which revealed the aspirated tracheostomy tube in the trachea and right main bronchus. Extraction was done by rigid bronchoscopy under general anesthesia. The postoperative course of the patient remain uneventful. In order to reduce the potentially fatal complications of the tracheotomy, it is necessary to insist on a regular medical follow-up.
Rajendram R, Khan MF, Joseph A. Tracheostomy tube displacement: An update on emergency airway management. Indian J Respir Care 2017;6:800-6.
Bassoe HH, Boe J. Broken tracheotomy tube as a foreign body. Lancet. 1960;1(7132):1006-7.
Singhal G, Kumar P, Goel S, Pathak A. A case of migration of fractured tracheostomy tube- a case presentation. Egypt J Otolaryngol. 2022;38:34.
Chakma A, Siddiqui OA, Ali S, Nadeem A. Track your trach: Removal of a fractured tracheostomy tube using a flexible fibreoptic bronchoscope in a patient with severe head injury. Med J Armed Forces India. 2021.
Amini K, Ogharood V, Davari M. A Case of A Fractured Fragment of Tracheostomy Tube Entering the Left Bronchus: A Case Report. J Babol University Med Sci. 2021;23(1):393-7.
Chehbouni M, Benhoummad O. Acute Respiratory Distress Revealing an Unrecognized Tracheostomy Cannula at the Bronchial Level in the Pandemic COVID Era. European J Med Health Sci. 2021;3(3):72-4.
Mulkalwar A, Rege S. Aspiration of a Fractured Tracheostomy Tube Managed by a Rigid Bronchoscopy via Tracheostomy Stoma in a Patient with Existing Airway Compromise. J Clin Images. 2021;4(1):1082.
Waindeskar V, Kumar S, Agrawal D. Tracheostomy Tube as Foreign Body in Right Main Bronchus: A Case Report. Indian J Otolaryngol Head Neck Surg. 2020.
Kashoob M, Al Washahi M, Tandon R. Aspiration Pneumonia Due to Migration of Fracture Tracheostomy Tube after 14 Years of Use. Oman Med J. 2020;35(2):113.
Hosur B, Ahuja CK, Virk RS, Singh P. Unusually dislodged tracheostomy tube with intact airway. BMJ Case Rep. 2020;13(7):e237195.
Tahira A, Khan T, Soura, Genie F. Broken tracheostomy tube presenting as tracheobronchial foreign body: a rare case report. World J Pharm Res. 2018;8(2):1012-4.
Wilson W, Nagaraja DM, Murthy S. Fracture and aspiration of tracheostomy tube: A case report. Hong Kong J Emerg Med. 2018;25(6):371-3.
Moideen SP, Arun G, Mohan M, Afroze KH. Fractured Tracheostomy Tube - An Unusual Foreign Body in Tracheobronchial Tree. BJOHNS. 2017;25(2):107-10.
Gupta SL, Swaminathan S, Ramya R, Parida S. Fractured tracheostomy tube presenting as a foreign body in a paediatric patient. BMJ Case Rep. 2016;2016:bcr2015213963.
Sathe NU, Ratna P, Shelke S, Krishnan K. Broken metallic tracheostomy tube migrating into the tracheobronchial tree. Surgical Techniques Develop. 2016;6(1):6466.
Indrajit R, Chandragupta C, Kumar J. Retrieval of Fractured Metallic Tracheostomy Tube – An Innovative Approach. Annals Int Med Dental Res. 2016; 2:1-2.
Ngern A, Boonsarngsuk V. Fractured metallic tracheostomy tube: A rare complication of tracheostomy. Respir Med Case Rep. 2016;19:46-8.
Loh TL, Chin R, Flynn P, Jayachandra S. Fracture and aspiration of a tracheostomy tube. BMJ Case Rep. 2014;2014:bcr2013203232.
Parida PK, Kalaiarasi R, Gopalakrishnan S, Saxena SK. Fractured and migrated tracheostomy tube in the tracheobronchial tree. Int J Pediatr Otorhinolaryngol. 2014;78(9):1472-5.
Poduval J, Benazir F, Ninan P. Pneumopericardium - an unusual complication of broken tracheostomy tube presenting as foreign body trachea . J Laryngol Voice. 2014;4:32-5.
Kusi AA, Ampofo MO, Mohammed DI, Addison W. Fractured tracheostomy tube – A case report of a 3-year old Ghanaian child. African J Emergency Med. 2012;2(3):114-6.
Krishnamurthy A, Vijayalakshmi R. Broken tracheostomy tube: A fractured mandate. J Emerg Trauma Shock. 2012;5(1):97-9.
Mahattanasakul P, Kaewkongka T, Sriprasart T. Fracture Outer Metallic Tracheostomy Tube as an Airway Foreign Body. Indian J Otolaryngol Head Neck Surgery. 2019;1-5.
Kemper BI, Rosica N, Myers EN, Sparkman T. Inner migration of the inner cannula: an unusual foreign body. Eye Ear Nose Throat Mon. 1972;51(7):257-8.
Alvi A, Zahtz GD. Fracture of a synthetic fenestrated tracheostomy tube: case report and review of the literature. Am J Otolaryngol. 1994;15(1):63-7.
Brockhurst PJ, Feltoe CK. Corrosion and fracture of a silver tracheostomy tube. J Laryngol Otol. 1991;105(1):48-9.