An unusual case of iatrogenic airway obstruction and its management in a low-resource setting.

Fibrinous or membranous tracheal lesions causing subglottic tracheal obstruction are an uncommon cause ofpotentially fatal complications after tracheal extubation.We report a case of 20-year-old male with two episodes ofapneic spells with airway obstruction following tracheal extubation at a community health centre which resolved spontaneously. The patient developed stridor and acute respiratory distress 2 days following tracheal extubation. On evaluation at our hospital, computed tomography chest revealed a tubular and curvilinear membrane in upper trachea at D1-D3 levels.Anurgent fibre optic bronchoscopy revealed a tracheal mucosal flap causing 80% obstruction of thesubglottic trachea which was suctioned out. The patient eventually made a full recovery. The low incidence of similarlesions and the lack of distinguishing clinical features from other causes of post-extubation stridormake diagnosis and appropriate management of this life-threatening condition difficult. We discussthis case of iatrogenic mucosal tear in the trachea which caused a one-way valve effect, obstructing the airway and manifesting as post-extubation stridor and how early consideration of the diagnosis and optimal management reduce the risk of anadverse outcome.