Tracheobronchomegaly causing endotracheal tube cuff leak

Abstract

Abstract We describe a 75 year old gentleman, admitted to intensive care unit, who develops a significant endotracheal cuff leak. After ruling out cuff puncture we discover the patient has tracheobronchomegaly on a CT thorax. The leak is highly positional but was managed successfully with careful ETT manoeuvring. We discuss the causes of ETT cuff leak and then explain the underlying mechanisms of tracheobronchomegaly.