CTICasesIatrogenic Tracheal Rupture from an Overinflated Endotracheal Tube Balloon
Imaging findings
In an intubated patient with severe neck and mediastinal infection, CT shows pronounced pneumomediastinum and subcutaneous emphysema with an overdistended endotracheal tube balloon; sagittal reformats show the markedly dilated balloon corresponding to a focal defect in the posterior tracheal membrane. Follow-up imaging after balloon deflation and tube repositioning shows near-complete resolution of the pneumomediastinum, though a residual tracheal wall defect remains visible.
Key takeaways
An overdistended endotracheal tube balloon at the site of a posterior membrane defect, with pneumomediastinum that improves once the balloon is deflated and the tube repositioned, indicates iatrogenic tracheal rupture from balloon overinflation (or from the intubation itself); bronchoscopy confirmed a roughly 5 cm linear posterior membrane tear, which was managed conservatively given the presence of healing granulation tissue.
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