Tracheal Injury After Endotracheal Intubation: Experience with Conservative Treatment in Two Infants

Iatrogenic tracheal injury is unusual, but a challenging complication in pediatric age group. Delayed diagnosis may result in increased orbidity and even mortality. There is no consensus between surgical and conservative management as treatment options in pediatric patients. Although surgery is still a life-saving procedure, conservative treatment has recently become an alternative to surgery in selected patients. In this paper, we present our experience with conservative management in 2 infants with tracheal injury after endotracheal intubation. Both patients presented with subcutaneous emphysema. The chest and neck roentgenogram and computed tomography showed findings highly suggestive of tracheal injury such as subcutaneous emphysema, pneumomediastinum and air leak around the trachea. The patients were followed-up conservatively, and clinical and radiological resolution of subcutaneous emphysema and pneumomediastinum was gradually observed. Finally, successful outcomes were achieved in both of the patients.