An 84-Year-Old Woman with Shortness of Breath and Low Oxygen Saturation: “Think Outside the Box”

Özet

An 84-year-old woman, who had been admitted to the emergency department (ED) several times because of dyspnoea, was treated for acuteexacerbation of chronic respiratory failure without satisfactory clinical improvement. According to her medical history, 8 years earlier, sheunderwent a complicated cardiosurgical procedure that required tracheostomy and mechanical ventilation in the post-operative period for 45days. Traditional X-Ray did not show any abnormal findings; however, high resolution thorax computed tomography (HRCT) scan revealed asevere tracheal stenosis, which was confirmed with bronchoscopy, and required immediate tracheostomy. Tracheal stenosis is a rare but severecomplication that should be suspected when a patient with previous tracheostomy presents to the ED with dyspnoea even if tracheostomy hadbeen closed many years before, because adaptive mechanism results in asymptomatic life for a long period.