Delayed Presentation of Tracheal Injury After Thyroidectomy—a Case Report

  • K. Devaraja
  • Rajeev Kumar
  • Prem Sagar
  • Rakesh Kumar
Case Report


Complications of thyroidectomy are common and few of these could be life threatening. Although rare, the delayed tracheal rupture is one such complication and needs to be managed promptly. A male patient presented with neck swelling and on evaluation diagnosed to have papillary carcinoma thyroid T4a N1b M0. Patient underwent total thyroidectomy and neck dissection. On post-operative day 5, he developed subcutaneous emphysema. The subcutaneous emphysema was managed non-surgically with close observation and took 6 days to resolve completely. Management algorithm has been formulated after literature review. Delayed subcutaneous emphysema following thyroidectomy can be managed non-surgically in selected cases with mild emphysema and non-progressive course.


Thyroidectomy Total thyroidectomy Tracheal rupture Subcutaneous emphysema Complications 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study. Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.


  1. 1.
    Caulley L, Johnson-Obaseki S, Luo L, Javidnia H (2017) Risk factors for postoperative complications in total thyroidectomy: a retrospective, risk-adjusted analysis from the National Surgical Quality Improvement Program. Medicine (Baltimore) 96:e5752CrossRefGoogle Scholar
  2. 2.
    To EWH, Tsang WM, Williams MD, Lai ECH, Chan M (2002) Tracheal necrosis and surgical emphysema: a rare complication of thyroidectomy. Ear Nose Throat J 81:738–741Google Scholar
  3. 3.
    Damrose EJ, Damrose JF (2009) Delayed tracheal rupture following thyroidectomy. Auris Nasus Larynx 36:113–115CrossRefPubMedGoogle Scholar
  4. 4.
    Mazeh H, Suwanabol PA, Schneider DF, Sippel RS (2012) Late manifestation of tracheal rupture after thyroidectomy: case report and literature review. Endocr Pract 18:e73–e76CrossRefPubMedGoogle Scholar
  5. 5.
    Bertolaccini L, Lauro C, Priotto R, Terzi A (2012) It sometimes happens: late tracheal rupture after total thyroidectomy. Interact Cardiovasc Thorac Surg 14:500–501CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Conzo G, Fiorelli A, Palazzo A, Stanzione F, Della Pietra C, Santini M (2012) An unpredicted case of tracheal necrosis following thyroidectomy. Ann Ital Chir 83:55–58PubMedGoogle Scholar
  7. 7.
    Sanna S, Monteverde M, Taurchini M, Mengozzi M, Genestreti G, Grossi W, Argnani D, Bettini D, Dell'Amore D (2014) It could suddenly happen: delayed rupture of the trachea after total thyroidectomy. A case report. G Chir 35:65–68PubMedPubMedCentralGoogle Scholar
  8. 8.
    Chauhan A, Ganguly M, Saidha N, Gulia P (2009) Tracheal necrosis with surgical emphysema following thyroidectomy. J Postgrad Med 55:193–195CrossRefPubMedGoogle Scholar

Copyright information

© Association of Surgeons of India 2018

Authors and Affiliations

  • K. Devaraja
    • 1
  • Rajeev Kumar
    • 2
  • Prem Sagar
    • 2
  • Rakesh Kumar
    • 2
    • 3
  1. 1.Department of Otorhinolaryngology and Head and Neck SurgeryKasturba Medical collegeManipalIndia
  2. 2.Department of Otorhinolaryngology and Head and Neck SurgeryAll India Institute of Medical SciencesNew DelhiIndia
  3. 3.Department of ENTAll India Institute of Medical SciencesNew DelhiIndia

Personalised recommendations