CTICasesIatrogenic Tracheal Rupture from an Overinflated Endotracheal Tube Balloon
[...]. Iatrogenic Tracheal Rupture from an Overinflated Endotracheal Tube Balloon. CTICases. Published March 23, 2018. https://cticases.com/c/xw652
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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