Life-Threatening Pneumomediastinum Following Tracheal Perforation as a Complication of Total Thyroidectomy: A Case Report

Total thyroidectomy, a common surgical procedure, is generally safe with a low morbidity and mortality rate. While complications such as hematoma and recurrent laryngeal nerve injury are well recognized, tracheal perforation is a rare but life-threatening event. We discuss the risk factors associated with tracheal perforation during thyroidectomy and review current best practices for its management. This case report describes a 55-year-old woman who experienced a rare but critical complication following total thyroidectomy: tracheal perforation leading to bilateral pneumothorax and mediastinal emphysema. The successful management of this patient, involving prompt reoperation, tracheostomy, chest tube placement, and antibiotic treatment for subsequent cervicomediastinal cellulitis, highlights the importance of early recognition and intervention in managing this life-threatening event.