Tracheal ring rupture and herniation during percutaneous dilatational tracheostomy identified by fibreoptic bronchoscopy.

We present a case of rupture and herniation of cartilaginous tracheal rings into the lumen of the trachea that was noticed as an incidental finding during bronchoscopy after percutaneous dilatational tracheostomy. While percutaneous methods of tracheostomy formation gain popularity in intensive care settings, the number of reported problems associated with this technique continue to grow. We propose that fibreoptic bronchoscopy used routinely with percutaneous tracheostomy formation will identify a number of complications involving the tracheal skeleton.