Paratracheal abscess after traumatic tracheal intubation

Abstract

Major complications of laryngoscopy and tracheal intubation are rare. However, mucosal trauma during airway management can lead to the introduction of oropharyngeal bacterial flora into the deep neck spaces, with the potential for fatal complications. This report describes the development of a paratracheal abscess in a healthy 62-year-old man following an outpatient herniorrhaphy. The patient was treated with intravenous antibiotics and underwent ultrasound-guided needle aspiration of the abscess. He was later re-admitted to the hospital with re-accumulation of the abscess, which was successfully treated by open surgical drainage. Though deep neck space infection following laryngoscopy is more common in patients with significant comorbidities and when tracheal intubation has been difficult, this case highlights the need for careful airway management in all patients.

Keywords: neck infection; paratracheal abscess; tracheal intubation; upper airway anatomy.

Figure 1

Contrast computed tomography scan of the neck showing axial (a), coronal (b) and sagittal (c) images of the left paratracheal abscess. The red arrowheads indicate the abscess.