Acute Stridor and Respiratory Failure due to Retrosternal Subglottic Stenosis of Unknown Origin

• Main Authors: Tharindu Vithanage, Gerben Keijzers, Nicola Jane Willis, Tara Cochrane, Linda Smith
• Format: Article
• Language: English
• Published: Hindawi Limited 2013-01-01
• Series: Case Reports in Emergency Medicine
• Online Access: http://dx.doi.org/10.1155/2013/728405

Respiratory failure due to subglottic stenosis is a rare but serious condition. A 22-year-old male presented to the emergency department (ED) with shortness of breath, stridor, and change in tone of voice. The patient did not complain of B-symptoms (fever, weight loss, and night sweats). In the week before this presentation, he was diagnosed with an upper respiratory tract infection with associated bronchospasm and discharged on oral antibiotics and inhaled salbutamol without effect. He developed hypercapnic respiratory failure in the ED after a coughing episode. A normal nasopharyngoscopic examination and a subtle mediastinal abnormality on chest radiograph lead to a working diagnosis of retrosternal subglottic obstruction. The complexities of his airway management and suggestions for multidisciplinary approach are discussed.