Presentation
Severe shortness of breath following bronchoscopy
Patient Data
Scout xray image of the chest demonstrating pneumomediastinum demonstrated by hypolucency outlining the cardiac borders and hemidiaphragms.
Air tracking along the retropharyngeal space and carotid space anterior to the cervical spine up to the level of the hypopharynx. Additional subcutaneous emphysema along the anterior neck soft tissues. Posterior tracheal wall discontinuity best seen on sagittal imaging, at the level of the cervicothoracic junction, suspicious for tracheal wall rupture.
Other: partially visualized spinal stimulator posterior to C4-C7.
Case Discussion
Tracheal perforation can be life threatening and is rarely associated with medical instrumentation including bronchoscopy. It can be characterized by the findings in the images above including pneumomediastinum and subcutaneous emphysema.
This case was submitted with supervision and input from:
Ryan Hoffman, D.O.
Mayo Clinic, Jacksonville
Department of Diagnostic and Interventional Radiology
Resident Radiologist
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