Fractured Metallic Tracheostomy Tube as an Unusual Foreign Body in The Left Main Bronchus: A Case Report.

Introduction: Tracheostomy is a vital airway procedure for critically ill patients with acute respiratory failure. This study presents a rare but serious complication: the fracture and migration of a tracheostomy tube into the tracheobronchial tree, and discusses its management.

Case presentation: A 43-year-old male, with a tracheostomy tube in place for 8 years following a neck blast injury, presented with a foreign body in his airway. Chest X-ray revealed a fractured metallic tracheostomy tube lodged in the left main bronchus. The tube was successfully removed by rigid bronchoscopy under general anesthesia, and the patient was discharged in good condition with a new tracheostomy tube.

Discussion: Tracheostomy tubes, typically made of polyvinyl chloride or metal, can fracture due to prolonged use without regular check-ups, or replacement. Patients may present with mild respiratory symptoms or be asymptomatic. Diagnosis is confirmed by X-ray, and removal is performed via rigid bronchoscopy.

Conclusion: Fractured tracheostomy tubes are a rare but potentially fatal complication requiring urgent bronchoscopy. Regular follow-up, proper care, timely tube replacement, and patient education are essential to prevent such occurrences.