Relapsing polychondritis with catastrophic tracheal injury: extracorporeal membrane oxygenation and silicone Y-stenting for salvage therapy.

Abstract

Background: Airway injury is a life-threatening condition requiring immediate intervention. Tracheal perforation in patients with relapsing polychondritis (RP) and tracheobronchomalacia (TBM) is extremely rare, posing significant management challenges. Here, we describe the successful placement of a silicone Y-stent via rigid bronchoscopy under venovenous extracorporeal membrane oxygenation (ECMO) to address this complex clinical scenario.

Case presentation: We present the case of a 29-year-old female with RP and tracheostomy tube dependence who developed tracheal rupture, resulting in acute respiratory failure. To stabilize her condition, venovenous ECMO was initiated, and a silicone Y-stent was successfully placed via rigid bronchoscopy. The patient achieved full recovery, and the stent was removed 10 months later, revealing complete airway healing.

Conclusions: This case highlights the effectiveness of silicone Y stenting and venovenous ECMO as viable salvage strategies for severe airway injuries in RP patients. Our findings demonstrate the safety and feasibility of this approach in managing complex airway conditions, offering a potential treatment option for similar cases.