Tracheobronchial injuries (TBI) are highly fatal, and early diagnosis and repair are crucial for survival. The anesthesiologist and the surgeon must secure the integrity and patency of the airway for these cases. These injuries remain infrequent, and are becoming less fatal due to the availability of the resources necessary to achieve a secure airway, and thus some of them can be managed conservatively. We report an unusual case of upper airway compromise and extensive subcutaneous emphysema due to traumatic bronchial rupture and its conservative repair in a patient with Down's syndrome.
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