Bilateral pneumothorax: Perils of emergency tracheostomy

Tracheostomy is a life-saving procedure performed in both emergency and elective setting. Development of bilateral pneumothorax in adults following tracheostomy is a rare complication. We report a case of bilateral iatrogenic pneumothorax in 33-year-old woman from rural Maharashtra in central India, immediately following emergency mid-level tracheostomy done for post- radiotherapy fibrosis with laryngeal perichondritis and retropharyngeal infection associated with prolonged dyspnea. No pleural injury or posterior tracheal wall injury had occurred. Sudden left-sided chest pain with immediate reoccurrence of dyspnea prompted us to do urgent chest X-ray. Bilateral pneumothorax was identified, more on the left side. The patient was treated with tube thoracostomy. The case is being reported to highlight the possibility of occurrence of this rare life-threatening complication due to the underlying mechanism in any case of emergency tracheostomy.