Tracheal rupture is a rare but potentially lethal injury. There are several causes; traumatic, neck surgery, tracheal dilatation and association to intubation. We describe a case of tracheal injury where the patient developed subcutaneous emphysema while coughing in the recovery room. Our patient did initially not complain of any breathing difficulties but after further coughing the emphysema increased and the patient became dyspnoeic. Emergent CT-imaging showed a tracheal injury and our patient was transport to ENT for stent therapy. It is important to recall the risk for tracheal injury. Subcutaneous emphysema and breathing difficulties with debut following extubation should raise the suspicion.

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