Bronchial rupture caused by intubation with a double-lumen endotracheal tube (DLT) is a rare but serious complication. We report a case of 60-year-old man with a diagnosis of metastatic lung adenocarcinoma who received general anesthesia for a right thoracotomy with a left-sided polyvinylchloride (PVC) double-lumen endobronchial tube (37Fr). Upon opening his chest wall, pneumomediastinum and a laceration wound over the left main-stem bronchus were found by the surgeon. The bronchial laceration was immediately repaired, and neither bronchial leak nor mediastinitis developed after surgery. The patient was discharged uneventfully 2 weeks later. Potential mechanisms and risk factors of DLT-induced bronchial rupture are discussed.
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