C. Febriandri*a (Mr), GA. Desiantia (Mrs), MF. Alatasa (Mr), E. Efriadia (Mr)

a Universitas Indonesia - Persahabatan Hospital, Jakarta, INDONESIA

* dr.christian.f20@gmail.com

Background: tracheal stenosis following prolonged intubation is a relatively rare but serious problem. There are various treatment modalities that can be perfomed as a single procedure and/or combined. Although balloon dilatation is effective and relatively easy to perform, still there were not many cases reporting successful treatment of ballon dilatation as single procedure in tracheal stenosis.

Case: we report a 43-year-old-man who presented dyspnea for two months. He previously was in ventilation assisted post-road traffic accident (RTA) for 7 days due to brain injury. He came to emergency room with stridor and need of oxygen supplement. A chest computed tomography scan showed pathological narrowing of trachea. Flexible bronchoscopy using therapeutic scope no. 5,8 revealed proximal tracheal stenosis with diameter 0.5 cm, lenght of stenosis 4 cm with 1.5 cm from vocal cord. The balloon dilatation using balloon number 12 then performed and the diameter of trachea increased 1.5 cm and symptoms relieved.

Conclusion: Tracheal balloon dilatation is initiated to enlarged the diameter of the airway. Multiple factors are responsible for stenosis caused by prolonged intubation. Tracheal stenosis occurs after intubation 7-19 days. The mechanism of balloon dilatation is to create some cracks at the stenotic site to expand the tracheal wall. Balloon dilatation is an easy and effective way to relieve tracheal stenosis and can be repeated safely several times. If the tracheal cartilages are not damaged, a good outcome can be achieved by single dilatation session. Excessive balloon inflation may cause rupture of the airway leading to hemorrhage, pneumothorax, pneumomediastinum, or mediastinitis.

Keyword: tracheal stenosis, balloon dilatation

Disclosure of funding source(s): none