Conservative Treatment of Delayed Tracheal Perforation Following Thyroidectomy

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Abstract

Objectives: To report on a patient who underwent a total thyroidectomy and re-presented three weeks later with significant subcutaneous emphysema due to a tracheal perforation.

Case report: A 42 year old man underwent a thyroidectomy to remove a papillary carcinoma. He re-presented three weeks later with a fluctuant anterior neck swelling which was reducible and increased in size on raised intra-thoracic pressure. A lateral neck x-ray showed a large pocket of air and a subsequent CT scan showed a small defect in the anterior tracheal wall. This was visualised with a rigid bronchoscopy and found to be a pin-sized perforation. The patient was managed conservatively and the swelling resolved over a period of 2 to 3 weeks.

Conclusions: Delayed post thyroidectomy tracheal perforation is a very rare complication. In this case the patient had no respiratory compromise and so conservative management was seen to be the best management option.

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Read 10014 times Last modified on Sunday, 01 December 2013 13:08

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