RATIONALE: Tracheobronchial injury from acid ingestion is a less reported clinical presentation than injury of the gastrointestinal tract, but it can occur due to direct exposure from acid aspiration and cause fatal complications.
PATIENT CONCERNS: A 43-year-old man presented to the emergency department after ingesting nitric acid complaining of chest pain and dyspnea.
DIAGNOSES: The initial chest computed tomography (CT) images revealed an acute lung injury related to acid aspiration. The follow-up chest CT showed acute and late tracheobronchial injures.
INTERVENTIONS: Bronchoscopy showed deep caustic airway injuries consisting of hemorrhage, sloughing of the mucosa, and ulceration of the trachea and left-side bronchial tree.
OUTCOMES: Progressive narrowing of the left main bronchus with total collapse of the left lung occurred as a late complication of acid ingestion.
LESSONS: Tracheobronchial injury should be considered in cases of aspiration pneumonia after acid ingestion; chest CT can be used to detect and assess acute and late complications of tracheobronchial injuries.