Upper airway obstruction by a fragmented tracheostomy tube: Case report and review of the literature

INTRODUCTION: Many objects were described in the literature as causes of upper airway obstruction including seeds, nuts and household particles but fragmented tracheostomy tube is a rarely reported cause of airway obstruction. We report a case of foreign body aspiration in the tracheobronchial tree due to a fragmented and migrated tracheostomy tube. PRESENTATION OF CASE: We report a 4.5 year old female patient who had upper airway obstruction due to a fragmented and migrated tracheostomy tube. She was diagnosed by chest X-ray and the tube was removed by rigid bronchoscopy. DISCUSSION: Several factors contribute to fragmentation of the tracheostomy tube including repeated removal and reinsertion, cleaning, boiling or chemicals. Early breakage is most often due to manufacturing defects. The occurrence of a fractured tracheostomy tube in children is rare. Nevertheless, tracheobronchial foreign bodies in children can be life threatening and pose a dire emergency. CONCLUSION: Based on our experience, the doctors and other staff should check for any manufacturing defects before the first use of a tracheostomy tube, which should reduce the occurrence of this rare, but life threatening.