Extensive tracheal injury in penetrating neck trauma – a case report and management discussion

摘要

BACKGROUND: Any penetrating trauma to the neck may cause damage to great vessels resulting in massive bleeding or injury to the trachea, esophagus or spinal cord. Such injuries sometimes pose a real intubation challenge. METHODS (CASE REPORT): We report a case of penetrating neck injury with isolated but extensive tracheal laceration. The sharp curved hook of a heavy automobile entered through suprasternal area of neck of a bike rider in a road accident. The patient presented with right-sided pneumothorax and respiratory collapse. Bronchoscopy revealed injuries at two sites in the trachea. The patient was intubated with unique method of double tube intubation. Injuries of trachea were repaired by right thoracotomy and midline cervicotomy. RESULTS: The patient made an uneventful recovery by this unique method of intubation and tracheal repair. CONCLUSIONS: Isolated tracheal injuries are very rare in penetrating road accident wounds and the intubation and operative strategy may change according to bronchoscopic findings.