Neonatal tracheal rupture complicating endotracheal intubation: a case report and indications for conservative management

Neonatal tracheal injury represents a rare complication of endotracheal intubation. Previous case reports have demonstrated high morbidity and mortality (75%) associated with the rapid occurrence of subcutaneous emphysema, respiratory failure and death in this patient population. This mandates the prompt recognition, evaluation and management of this injury in the neonate. Although there is no clear consensus, previous authors have described both surgical therapy and expectant management. We report a case of a newborn who sustained tracheal rupture following traumatic intubation who survived with expectant management. The pathophysiology, management and indications for conservative management of neonatal tracheal rupture are reviewed.