Cyanoacrylate glue topical adhesive for bronchoscopic repair of tracheal laceration.

Iatrogenic tracheal laceration (ITL) is a rare and potentially life-threatening complication of endotracheal intubation. The lacerations most commonly occur at the posterior membrane and in emergency and difficult intubations. There is no consensus regarding the optimal management of ITL. Small lacerations can be managed conservatively; however, surgical repair might be indicated for large lacerations, patients with progressive symptoms or those with haemodynamic instability. In this report, we present a case of a 3cm iatrogenic posterior membrane laceration following emergency intubation, which resulted in extensive subcutaneous emphysema and pneumomediastinum. This was successfully treated with cyanoacrylate glue (Histoacryl Topical Skin Adhesive, Tissue Seal) instilled via a flexible bronchoscope. The tear was completely sealed following the procedure. While cyanoacrylate glue (Histoacryl) has been successfully used for the management of bronchopleural fistulas in the past, to our knowledge, this is the first documented use of this adhesive for the management of ITL.