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Case Reports
. 2017 Feb 24:2017:bcr2016218948.
doi: 10.1136/bcr-2016-218948.

Emergency cricothyroidotomy following tracheobronchial stenting

Simon Robert Cavinato  1 , Mike Denning  2 , Brendan P Madden  3
Affiliations
Case Reports

Emergency cricothyroidotomy following tracheobronchial stenting

Simon Robert Cavinato et al. BMJ Case Rep. .

Abstract

A man aged 51 years was referred for tracheobronchial stenting after a poorly differentiated oesophageal carcinoma had progressed to cause stridor. Bronchoscopy revealed a left vocal cord palsy and tumour infiltration into the trachea. A tracheobronchial stent was placed, and after distal migration was endoscopically resited. Returning from theatre, the patient developed severe upper airway obstruction that progressed to cause CO2 narcosis and loss of consciousness. A rapid sequence induction was initiated, and a Glidescope revealed bilateral vocal cord palsy with severe oedema causing an inability to pass a tube or stylet. Tracheostomy was attempted above the suprasternal notch but was obstructed by the stent. Oxygen saturations dropped steadily, reaching as low as 38%. Emergency cricothyroidotomy was performed, compliant with DAS guidelines, that proved successful. The stent was removed, which was blocked with blood and secretions, and tracheostomy was placed 2 days later. The patient made a full neurological recovery.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Self-expandable metallic stent after removal from the trachea, showing blockage with blood and secretions.
See this image and copyright information in PMC

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