Iatrogenic tracheal rupture during intubation with a double-lumen tube.

Iatrogenic tracheal rupture after intubation with a double-lumen endotracheal tube is rare. An endobronchial tube positioning guide stylet, which is generally used during intubations with a double-lumen tube, may tear the trachea. A 76-year-old patient with right upper lobe carcinoma was scheduled for videothoracoscopic lobectomy. Mediastinal lymph node dissection was performed after a right upper lobectomy. When the mediastinal pleura in the right paratracheal region were opened, a tracheal cuff was noticed in the mediastinum. The tear in the membranous part of the trachea was repaired. Use of stylets during intubation may cause tracheal injury. To prevent such an injury, the stylet should be withdrawn after the tip of the tube has passed through the vocal cords.