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Tracheal rupture is a rare condition usually caused by a penetrative or blunt trauma to the cervix or thorax. Tracheal intubation and surgical manipulation of the cervix can be also responsible for this complication, but the rupture is usually recognized intraoperatively and can be easily repaired. Only a few cases of delayed tracheal rupture after thyroidectomy are reported, all of them during the first 2 postoperative weeks.1
A case of a 55-year-old woman who underwent total thyroidectomy for multinodular goiter and returned 40 days later in our department with subcutaneous emphysema is presented (Fig. 1). The emphysema was caused by a delayed tracheal perforation and to our knowledge, this is the most delayed reported presentation of a tracheal rupture after thyroidectomy.
Her only symptoms were a feeling of swelling and distension without any respiratory deterioration. The patient was free of a medical history and the operation was conducted using electrocautery and harmonic scalpel. The postoperative period was uneventful, and the patient was discharged on the first postoperative day. Her symptoms started the 40th postoperative day and 1 day later she sought for medical guidance. An initial chest x-ray excluded a pneumothorax and pneumomediastinum. The emphysema...