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Sudden Airway Collapse After Pneumoperitoneum With Undiagnosed Tracheomalacia in a Morbidly Obese 12-Year-Old Boy Undergoing Laparoscopic Cholecystectomy: A Case Report

Kojima, Taiki MD; Kandil, Ali I. DO, MPH; Previte, Joseph P. MD, FAAP

doi: 10.1213/XAA.0000000000000950
Case Reports

Tracheomalacia is characterized by the collapse of the tracheal wall due to the softening of the tracheal cartilage and myoelastic tissues. We describe the case of a 12-year-old morbidly obese boy, without previous medical issues, scheduled for elective laparoscopic cholecystectomy. Immediately after pneumoperitoneum was established, mechanical ventilation could not be performed. Intraoperative exploration with flexible bronchoscopy showed that the tip of the endotracheal tube was nearly occluded by the posterior tracheal wall bulging anteriorly. Anesthesiologists should be aware of undiagnosed tracheomalacia as a cause of sudden airway collapse, even after the airway is secured with an endotracheal tube.

From the Department of Anesthesiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio.

Accepted for publication November 13, 2018.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Taiki Kojima, MD, Department of Anesthesiology, Cincinnati Children’s Hospital Medical Center, Room 337, CCHMC Main Bldg, 3333 Burnet Ave, Cincinnati, OH 45229. Address e-mail to

Copyright © 2018 International Anesthesia Research Society
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