Tracheal Air Leakage After Orotracheal Intubation in a Patient with Cricoid Fracture

A comatose 55-year-old man presenting with a horizontal abrasion on the anterior neck was sent to the emergency department after a motor vehicle accident. Swollen supraglottis and displaced vocal cords were noted on endotracheal intubation after which subcutaneous emphysema developed. Computed tomography showed cricoid fracture with air leak through an injury on the trachea distal to the cuff of the endotracheal tube. After pericardiocentesis for pericardial effusion, the patient expired following hemodynamic collapse. The results indicate that tracheobronchial injury is a critical condition that should be considered in patients with blunt chest or neck trauma. It is mandatory to identify other associated injuries to the respiratory and cardiovascular systems after establishment of advanced airway. Fiberoptic-guided intubation might be considered for patients with tracheal injury.