Broken tracheostomy tube: A fractured mandate

Abstract

Tracheostomy is a common airway procedure for life support. This procedure is safe, although occasional early and late complications are known to occur. Fracture and hence aspiration of a tracheostomy tube in the tracheobronchial tree is a rare late complication, which can be potentially life threatening. Published reports of a fractured tracheostomy tube presenting as a foreign body in the tracheobronchial tree are few. The most common dislodged sites reported were the trachea and the right main bronchus, the inner flange in our patient was lodged in the trachea and the left main bronchus. Foreign-body aspiration is a serious medical emergency demanding timely recognition and prompt action as was successfully done in our patient. Therapeutic rigid bronchoscopic removal is the mainstay of treatment. A periodic review of the techniques of tracheostomy care including timely check-ups for signs of wear and tear can possibly eliminate such avoidable late complications.

Keywords: Broken tracheostomy tube; complications; tracheostomy care.

Figure 1

Chest X-ray clearly outlined the metallic density of the inner flange, lodged partly in the trachea and partly along the left main bronchus

Figure 2

Bronchoscopy demonstrating the fractured inner flange of the metallic tracheostomy tube

Figure 3

The fractured inner flange of the metallic tracheostomy tube following rigid bronchoscopic removal