Obstructive fibrinous tracheal pseudomembrane complicated with bronchial mucus plug: A rare post-intubation complication case report.

Abstract

Background: Obstructive fibrinous tracheal pseudomembrane (OFTP) is a rare complication associated with endotracheal intubation. Elderly patients constitute a high-risk population for bronchial mucus plugging and sputum retention, either of which can lead to tracheal narrowing or even complete obstruction.

Case presentation: We present the case of an 80-year-old female who developed chest tightness and dyspnea two days after extubation following a video-assisted thoracoscopic left upper lobectomy. After transfer to the intensive care unit, bronchoscopy was performed, revealing subglottic pseudomembrane-like material. Several pieces of irregular gray-white tissue were removed from the trachea using biopsy forceps to clear the foreign body. The patient was discharged one week later and was followed up in the outpatient clinic after two weeks, with no recurrence of subglottic pseudomembrane observed.

Conclusions: OFTP is a rare cause of fatal airway obstruction following extubation and is often difficult to identify immediately. Mucus plugs frequently occur in elderly patients and can be directly visualized via bronchoscopy. Both conditions can be treated effectively through bronchoscopic removal.