International Clinical and Medical Case Reports Journal (ISSN: 2832-5788) | Volume 5, Issue 1 | Case Report | Open Access DOI
Mikhael Makhoul*
Mikhael Makhoul1*, Georges Dabar2, Antoine E Melkane1
1Department of Otolaryngology–Head and Neck Surgery, Hotel Dieu de France Hospital, Saint Joseph University, Alfred Naccache Boulevard, PO Box: 166830 Ashrafieh, Beirut, Lebanon
2Department of Pulmonology and Critical Care, Hotel Dieu de France Hospital, Saint Joseph University, Alfred Naccache Boulevard, PO Box: 166830 Ashrafieh, Beirut, Lebanon
*Correspondence to: Mikhael Makhoul
Fulltext PDFWe report the case of a 42-year-old man with a history of tracheal stenosis secondary to prolonged orotracheal intubation. He was then tracheotomized for acute respiratory distress. He subsequently underwent tracheoplasty and multiple tracheal balloon dilations, with a very satisfactory functional result. However, due to his critical lung condition, decannulation was deferred. The patient presented to our emergency department in acute respiratory distress, following a direct blow to his neck. A quick physical assessment revealed a loosely hanging tracheostomy-tube-plate around his neck. He was immediately transferred to the operation room and the cannula was extracted through cervical and bronchoscopic approach. A fenestrated cuffed #6 tracheostomy tube was inserted, and the patient was stabilized. Fifteen minutes later, we started observing a rapid drop in O2 saturation from 98% to 60%. A chest X-ray revealed a severe pulmonary edema. Despite appropriate treatment, the oxygen saturation was barely reaching 60% and he presented a cardio-respiratory arrest. Post obstructive pulmonary edema (POPE) is a potentially life-threatening acute respiratory failure. Two types of POPE are described: type I caused by increased inspiratory effort from acute airway obstruction and type II, caused by sudden relief of a chronic partial airway obstruction.
To our knowledge, only two cases of type Ⅱ POPE secondary to the removal of a bronchial foreign body in the last 2 decades were reported. The diagnosis is based on the patient's medical history, clinical characteristics, and radiological results. Treatment strategy will include endotracheal intubation and positive pressure ventilation with supplemental oxygen.
Mikhael Makhoul, Georges Dabar, Antoine E Melkane. Severe Pulmonary Edema Following Extraction of a Tracheal Foreign Body: A Case Report. Int Clinc Med Case Rep Jour. 2026;5(1):1-6.