What happened, in summary

An 81-year-old man underwent surgery for a 1.6 cm adenocarcinoma in the left upper lung. A left upper lobectomy with systematic lymph-node dissection was completed, but within hours he developed major postoperative bleeding and required an emergency return to the operating room. Over the following days, a persistent air leak and worsening subcutaneous emphysema raised concern for an airway injury. Bronchoscopy eventually identified a tracheal wall defect near the level of the breathing-tube cuff. Initial conservative care did not resolve the problem, so the trachea was surgically repaired on postoperative day 13. His lung expansion and air leak initially improved after repair, and he was later extubated. The hospital course remained complicated, however, with right-lung consolidation followed by gastrointestinal bleeding, low platelets and worsening respiratory and circulatory instability. He died on postoperative day 37 despite supportive treatment. The fatal outcome occurred in the setting of severe postoperative complications after lung-cancer surgery rather than documented cancer progression.