Fractured tracheostomy tube obturator: A rare cause of respiratory distress in a tracheostomized patient

Abstract

Foreign body aspiration is a worldwide health problem which often results in life threatening complications. Tracheostomy tube fracture resulting in airway obstruction is a serious condition which has been reported in the medical literature. We report a rare case of a tracheostomy obturator fractured and lodged in tracheobronchial tree in a patient who presented with acute respiratory distress. Rigid or flexible bronchoscopy is frequently necessary for the diagnosis as well as the treatment. In adults, removal of the foreign body can be attempted during a diagnostic examination with a fiberoptic bronchoscope under lignocaine local infiltration with sedation, which may help to avoid any further invasive procedures. Flexible bronchoscopy should always be considered in foreign body aspiration. A periodic review of the techniques of tracheostomy care, including timely check-ups for signs of wear and tear, can possibly eliminate such avoidable late complications.

Keywords: Respiratory distress, Tracheostomy, Foreign body, Aspiration, Bronchoscopy

Core tip: Foreign body aspiration is often a serious medical condition that demands timely recognition and prompt action. Delayed diagnosis and subsequent delayed treatment is associated with serious and sometimes life threatening complications. We describe a case of acute respiratory distress following aspiration of part of the obturator of a tracheostomy tube during a routine change of the tracheostomy tube.