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Iatrogenic Tracheal Laceration Causing Asphyxia

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Endotracheal intubation is a simple, rapid, and safe technique that is being used as a standard procedure for airway management. However, airway injury during endotracheal intubation could be a significant source of morbidity or even mortality for patients and a source of liability for physicians as well. We report an unusual case of fatal tracheal occlusion by intraluminal blood clot complicating endotracheal intubation. The patient, a 62-year-old woman, with renovascular hypertension and incipient renal failure was scheduled for renal autotransplantation. The surgery was uneventful but the postoperative course was complicated with a lethal airway obstruction. At autopsy a linear longitudinal tracheal laceration was identified with an intraluminal blood clot obstructing the tracheal lumen. Tracheal laceration as a cause of death is a rare and potentially fatal complication of endotracheal intubation with intratracheal bleeding, clot formation, tracheal occlusion, and subsequent asphyxia.
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Keywords: asphyxia; forensic science; intratracheal intubation; tracheal occlusion

Document Type: Research Article

Affiliations: 1: Department of Neuropathology, Clinical Hospital Center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia. 2: Department of Anesthesiology, Reanimatology and Intensive Care Medicine, Clinical Hospital Center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia. 3: Department of Urology, Clinical Hospital Center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia. 4: Department of Forensic Medicine and Criminology, School of Medicine, University of Zagreb, Šalata 11, 10000 Zagreb, Croatia.

Publication date: September 1, 2008

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