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Tracheal Injury
Trachea Injury

Presentation

We present a case of neonatal tracheal injury following delivery at term that presented with subcutaneous emphysema and pneumomediastinum before any attempt at intubation. The clinical course, treatment, and outcome are described. [ncbi.nlm.nih.gov]

Longitudinal tears extending into the right main bronchus were present in both the membranous and cartilaginous portions of the distal tracheal segment. [atsjournals.org]

Respiratoric

  • Cough

    Reference: coughing fit, fit of coughing, woop Reference information: zacenjivanje – whoop (kašljem) fit of coughing [Mićić S, Medicinski rečnik en-sr/sr-en] “Basic otorhinolaryngology: a step-by-step learning guide Autor: Rudolf Probst,Gerhard Grevers [proz.com]

    We describe a case of tracheal injury where the patient developed subcutaneous emphysema while coughing in the recovery room. [svemedplus.kib.ki.se]

    We guessed that the over-inflation of the cuff made the tracheal wall weak, and sudden movement of the tube during the vigorous coughing caused the tracheal injury. [anesthpain.com]

    […] causes Motor vehicle accident: extended neck impacts on steering wheel or dashboard "Clothes line injury", assaults/strangulation Penetrating trauma (usually stabbings or gunshot wounds) Clinical Features Respiratory distress Hoarseness, dysphonia, cough [wikem.org]

    Bruising on the neck Coughing blood Neck swelling Laryngeal trauma as seen during an endoscopic exam If trauma to the larynx is suspected, the doctor will do a few things to confirm the diagnosis. [chop.edu]

  • Hoarseness

    In three patients, breathing and swallowing functions had recovered at 2 weeks, but hoarseness continued. [sjtrem.biomedcentral.com]

    On arrival, he had one episode of mild haemoptysis and reported pain around the base of the neck and voice hoarseness. His chest X-ray revealed pneumopericardium and CT of thorax showed airway oedema. [ncbi.nlm.nih.gov]

    […] multisystem trauma Common causes Motor vehicle accident: extended neck impacts on steering wheel or dashboard "Clothes line injury", assaults/strangulation Penetrating trauma (usually stabbings or gunshot wounds) Clinical Features Respiratory distress Hoarseness [wikem.org]

    If the child's voice is hoarse then a flexible laryngoscopy can be used in the emergency room to visualize the vocal cords for hematomas or disruption. If the child's condition is stable, they may have a CT scan of the neck and chest. [chop.edu]

    He had respiratory discomfort but no hoarseness. The patient was given lactated Ringer's solution i.v. and kept warm during the rescue effort; he was pulled away 1.5 h after the accident. [onlinelibrary.wiley.com]

  • Stridor

    Motor vehicle accident: extended neck impacts on steering wheel or dashboard "Clothes line injury", assaults/strangulation Penetrating trauma (usually stabbings or gunshot wounds) Clinical Features Respiratory distress Hoarseness, dysphonia, cough, stridor [wikem.org]

    In mild croup, your child may have stridor only when crying or coughing. If croup gets worse, your child may also have stridor when relaxed or sleeping, and may have trouble breathing. [aboutkidshealth.ca]

    Signs and symptoms of laryngeal trauma include: View this video with a transcript Difficulty speaking or making sounds Change in voice (hoarseness) Noisy breathing (stridor) Respiratory distress Complaints of neck pain or pain when swallowing or coughing [chop.edu]

    Signs & Symptoms Stridor and dyspnea are the most common symptoms. The noisy breathing that characterizes stridor can resemble (and is often mistaken for) wheezing. [rarediseases.org]

  • Hemoptysis

    The study was carried out in hemodynamically stable patients who were suspected of having tracheal injury based on clinical manifestations such as hemoptysis, or cervical subcutaneous, deep cervical, or mediastinal emphysema. [ncbi.nlm.nih.gov]

    […] wheel or dashboard "Clothes line injury", assaults/strangulation Penetrating trauma (usually stabbings or gunshot wounds) Clinical Features Respiratory distress Hoarseness, dysphonia, cough, stridor, dysphagia Subcutaneous emphysema Cervical ecchymosis Hemoptysis [wikem.org]

    Features of partial tracheal rupture include gradually increasing dyspnea, hemoptysis, hoarseness, and subcutaneous emphysema. [sjtrem.biomedcentral.com]

    Physicians need to maintain a high index of suspicion related to non-specific signs such as dyspnea, cough, subcutaneous emphysema and hemoptysis [8]. [academic.oup.com]

    Most of the hemoptysis caused by tracheal injury is slight, but it can also present with massive hemoptysis if there is bronchial artery injury or tracheal fistula with high mortality (5). [jtd.amegroups.com]

Gastrointestinal

  • Constipation

    […] affects bladder control Constipation can cause accidential leakage from your bladder. [continence.org.au]

Musculoskeletal

  • Contusion

    […] dysphonia, cough, stridor, dysphagia Subcutaneous emphysema Cervical ecchymosis Hemoptysis Tracheal deviation or abnormal laryngeal contour Differential Diagnosis Thoracic Trauma Airway/Pulmonary Bronchial injury Diaphragm injury Hemothorax Pulmonary contusion [wikem.org]

    Bronchoscopy revealed deformation of the cartilage crescent in the cervical trachea (suggestive of cartilage contusion) and a longitudinal tear in the membranous region. [ncbi.nlm.nih.gov]

    The patient had multiple fractures of the left ribs, bilateral pneumothorax, left lung contusion, fracture of the sternum, and right open fracture of the fibula with contused wounds; he underwent tracheoplasty. [onlinelibrary.wiley.com]

    Related posts: Cardiac Contusion—Myocardial Contusion A cardiac contusion is a complication of an injury such as are often sustained in a car accident. A myocardial contusion, also known as a cardiac cont... [noonanlawma.com]

    Patients complicated with pulmonary contusion should be kept intubation with the support of ventilation. [jtd.amegroups.com]

Psychiatrical

  • Withdrawn

    At the end of the repair, the endotracheal tube was withdrawn a little to ensure that there was no inadvertent suturing of the airway tube. Filling the hemithorax with saline and insufflating with air assessed the integrity of the repair. [tropicalgastro.com]

    At the end of tracheal repair the endo-tracheal tube was withdrawn to ensure there was no inadvertent suturing of the airway tube. The gastric tube was advanced into the neck, anastomosed to esophageal stump and the procedure completed. [webmedcentral.com]

    Two surgical patients did not survive: 1 died on postoperative day 2 of a massive embolism,4 and 1 had care withdrawn because of brain death secondary to hypoxia.15 It is assumed that the more severe injuries necessitated surgical repair and were not [jamanetwork.com]

    The ETT was withdrawn to above the proximal extent of the defect and meropenem for suspected mediastinitis (penicillin allergy). [ijccm.org]

Workup

Clinical Testing and Workup A diagnosis of subglottic stenosis may be suspected based on the results of pulmonary function tests. [rarediseases.org]

X-Ray

  • Pneumoperitoneum

    In the first case, abdominal distension and subsequent tension pneumoperitoneum occurred after relief of acute airway obstruction owing to a tracheal membranous flap being released. [ijccm.org]

    One patient presented also with pneumoperitoneum (14%). Figure 1: CT scan showing both mediastinal emphysema and subcutaneous emphysema. [omicsonline.org]

    Other signs include dyspnea, dysphonia, cough, hemoptysis, and pneumoperitoneum [2, 18, 19, 26–28]. These signs often develop immediately or soon after extubation, though they can take several days to appear. [academic.oup.com]

Treatment

In patients with tracheal injuries, conservative treatment is an alternative approach when surgical treatment is difficult. [ncbi.nlm.nih.gov]

Treatment of tracheal injury Conservative treatment The simple airway mucosal tearing is always self-limited without any special treatment. [jtd.amegroups.com]

Prognosis

Prognosis and Long-Term Outlook Mortality from associated injuries in a penetrating injury to the neck can be as high as 50%; this is due to the close proximity of major blood vessels to the trachea. [pagelaw.com]

However, the prevalence of several risk factors for tinea cruris, such as obesity and diabetes mellitus, is rapidly increasing among adolescents. [4] Prognosis The prognosis of tinea cruris is excellent with appropriate diagnosis and treatment; however [emedicine.medscape.com]

Prognosis is usually benign, but some cases with an acute progression and a lethal outcome have been described. [ncbi.nlm.nih.gov]

Etiology

Etiologies of non-penetrating tracheobronchial injuries include blunt cervical trauma, endotracheal intubation, and other iatrogenic causes. [ncbi.nlm.nih.gov]

The etiologic agents in tinea cruris produce keratinases, which allow invasion of the cornified cell layer of the epidermis. The host immune response may prevent deeper invasion. [emedicine.medscape.com]

Iran. 61 Rashidian S...Zaini F 28681000 2015 48 Diagnosis directs treatment in fungal infections of the skin. 61 Panthagani AP...Tidman MJ 26738249 2015 49 Dermatophytosis in patients with human immunodeficiency virus infection: clinical aspects and etiologic [malacards.org]

Epidemiology

Rural-Based Tertiary Health Care Center. 61 Pariath K...Nair PA 31543529 2019 5 Prevalence and clinical characteristics of itch in epidemic-like scenario of dermatophytoses in India: a cross-sectional study. 61 Verma S...Szepietowski JC 31419346 2019 6 Epidemiology [malacards.org]

Epidemiology Frequency United States Dermatophytosis accounts for approximately 10-20% of all visits to dermatologists. [1] International Tinea cruris has a worldwide distribution but is found more commonly in hot humid climates. [2, 3] Sex Tinea cruris [emedicine.medscape.com]

Airway trauma: a review on epidemiology, mechanisms of injury, diagnosis and treatment. J Cardiothorac Surg. 2014 Jun 30;9:117. [PMC free article: PMC4104740] [PubMed: 24980209] 9. Chu CP, Chen PP. [ncbi.nlm.nih.gov]

Airway trauma: a review on epidemiology, mechanisms of injury, diagnosis and treatment. [cardiothoracicsurgery.biomedcentral.com]

Pathophysiology

Pathophysiology The most common etiologic agents for tinea cruris include Trichophyton rubrum and Epidermophyton floccosum; less commonly Trichophyton mentagrophytes and Trichophyton verrucosum are involved. [emedicine.medscape.com]

Chhabra A, Rudingwa P, Selvam PSR, (2013) Pathophysiology and management of Airway Trauma. Trends in Anaesthesia and Critical Care 3: 216. Hurford WE, Peralta R (2003) Management of tracheal trauma. pp: 17-R22. [omicsonline.org]

Mortality is relatively high in patients with acute trauma to the trachea with a reported 15% to 40% range depending on mechanism and classification.[4] Pathophysiology Tracheal disruption may involve tracheal cartilages (most commonly from direct, blunt [ncbi.nlm.nih.gov]

Prevention

You must act quickly to ensure airway patency, while preventing further injury in cases of spinal trauma. [blog.sscor.com]

The temper of the disc prevents any disc wrinkling from occurring during application. [buyhandh.com]

Control any athlete's foot infection to prevent its spread to the groin. If you spend time in moist public areas, such as a gym shower, wearing sandals will help prevent athlete's foot. Dec. 14, 2018 Ely JW, et al. [mayoclinic.org]

In two patients, tracheal stenosis prevented extubation and required further surgery; in these patients breathing and swallowing functions had recovered at 6 months. [sjtrem.biomedcentral.com]

The described surgical approaches are transcervical, transthoracic or median sternotomy. [18 ] The potential benefits of surgery are: 1) closure of the defect to facilitate effective ventilation, 2) prevent mediastinitis due to contamination from non [tropicalgastro.com]

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