PMC6394355_01
Endoscopic view. A - Tracheal stenosis (white arrow) at the fourth tracheal ring and a narrow remaining lumen (black arrow); B - Post-resection of the necrotic tissue. Note the enlargement of the tracheal lumen.
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The suspension videolaringoscopy evidenced ulcers in the lateral and posterior walls of the trachea, and necrosis of the mucosa at the fifth tracheal ring (Figure 2A). At the end of the procedure, the trachea resumed an almost normal caliber (Figure 2B).
Gross appearance of the surgical specimen represented by tracheal necrosis.
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The histopathological examination of the surgical specimen was represented by tracheal necrosis (Figure 3).
Endoscopic view. A - Scarring fibrotic stenosis 9 days after the exeresis of the necrotic tissue; B - Iatrogenic injury of the trachea with a false path (black arrow).
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A new rigid and eccentric stenosis was diagnosed (Figure 4A). The patient remained intubated for 24 hours and another suspended videolaringoscopy found a false path in the posterior tracheal wall measuring 4 cm, which extended 5 cm from the cricoid cartilage and 4 cm from the carina (Figure 4B).
Endoscopic view of the silicon endoprosthesis placed along the entire tracheal lesion.
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Thoracic computed tomography. A - Axial plane showing the endoprosthesis inserted in the trachea, and a posterior airspace corresponding to the traumatic false path (white arrow); B - Coronal plane showing the endoprosthesis placed in the middle third of the trachea (white arrow) surrounded by pneumomediastinum (arrowhead).
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Angeles-A esophagitis and biliary reflux. A control thoracic CT showed pneumomediastinum, a pneumothorax, extensive cervical subcutaneous emphysema, and a prosthesis surrounded by gas in the thoracocervical transition (Figure 6).