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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]
  • We present a novel approach to the repair of this type of injury using combined endovascular and open techniques.[ncbi.nlm.nih.gov]
  • Abstract Two cases are presented of severe tracheal damage secondary to low-pressure high-volume endotracheal tube cuffs monitored carefully against over-inflation.[ncbi.nlm.nih.gov]
  • We report the cases of three patients presenting tracheal laceration due to traumatic orotracheal intubation, two submitted to surgical treatment and one submitted to conservative treatment.[ncbi.nlm.nih.gov]
  • We present a case of a critically ill patient undergoing percutaneous dilation tracheostomy complicated by tracheal wall injury and airway loss. The airway was successfully conservatively managed as well as the tracheal injury.[ncbi.nlm.nih.gov]
Cough
  • Other possible symptoms include pain and coughing up blood. Treatment will consist of surgical repair of the trachea. After surgery, you may require a breathing tube while the trachea heals to ensure swelling does not constrict the airway.[pagelaw.com]
  • Difficulty breathing, coughing up blood and pain are other prominent symptoms of a neck injury. The trachea also contains the body’s vocal cords and injury to the trachea can change the voice making it hoarse.[noonanlawma.com]
  • This report is the first pediatric case of a spontaneous longitudinal laceration of the posterior membranous cervical trachea, which occurred after violent coughing in a 7-year-old boy with acute tracheobronchitis.[pediatrics.aappublications.org]
  • Symptoms may include: Coughing up blood Bubbles of air that can be felt underneath the skin of the chest, neck, arms, and trunk ( subcutaneous emphysema ) Difficulty breathing People who have had a trauma will need to have their injuries treated.[medlineplus.gov]
  • In addition to a feeling of fatigue or a general feeling being unwell (malaise), the symptoms of tracheal stenosis typically are: Wheezing, coughing or shortness of breath, including difficulty breathing A high-pitched squeal coming from your lungs when[cedars-sinai.edu]
Flank Pain
  • Kidney Trauma/Renal Failure Those suffering from renal injuries typically complain of abdominal or flank pain. It is critical that medical professionals undertake a urinalysis an...[noonanlawma.com]

Treatment

  • Abstract In patients with tracheal injuries, conservative treatment is an alternative approach when surgical treatment is difficult.[ncbi.nlm.nih.gov]
  • Several options for treatment ranging from conservative to surgical exist, but no single treatment has been implemented with consensus.[ncbi.nlm.nih.gov]
  • We report the cases of three patients presenting tracheal laceration due to traumatic orotracheal intubation, two submitted to surgical treatment and one submitted to conservative treatment.[ncbi.nlm.nih.gov]
  • The clinical course, treatment, and outcome are described.[ncbi.nlm.nih.gov]
  • Treatment was by operative primary closure. A collective review of blunt upper thoracic esophageal perforations reveals a nearly uniform occurrence of associated tracheal injury.[ncbi.nlm.nih.gov]

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]
  • Prognosis is usually benign, but some cases with an acute progression and a lethal outcome have been described.[ncbi.nlm.nih.gov]
  • Tracheal rupture leads to higher mortality and poorer prognosis especial for closed tracheal rupture which is hard to early diagnose and is generally fatal.[omicsonline.org]
  • This hypothesis is based upon observations that iatrogenic lesions usually present themselves as longitudinal tears of the posterior tracheal wall, and that tissue healing is usually simpler and with a better prognosis when compared with other etiology[omicsonline.org]

Etiology

  • We identified clinical manifestations and treatments of complications associated with endotracheal tubes and codified them into International Classification of Disease-ninth revision diagnosis and procedure codes, intentionally excluding alternative etiologies[ncbi.nlm.nih.gov]
  • Etiologies of non-penetrating tracheobronchial injuries include blunt cervical trauma, endotracheal intubation, and other iatrogenic causes.[ncbi.nlm.nih.gov]
  • It is obscure whatever these disease could be etiologically or fortuitously associated but a relationship cannot be completely excluded.[ncbi.nlm.nih.gov]
  • Etiology The injury occurred in one case during single-lumen tube intubation in emergency setting, and in elective situation in two patients.[omicsonline.org]

Epidemiology

  • References Prokakis C, Koletsis E, Dedeilias P, et al: Airway trauma: a review on epidemiology, mechanisms of injury, diagnosis and treatment. J Cardiothorac Surg 2014;9:117. Altinok T, Can A: Management of tracheobronchial injuries.[karger.com]
  • Review Epidemiology The true incidence of TBI is still unknown as 30–80% of these trauma victims still die at the scene of the accident[ 3 ].[cardiothoracicsurgery.biomedcentral.com]
Sex distribution
Age distribution

Pathophysiology

  • 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]
  • View Article PubMed Google Scholar Chhabra A, Rudigwa P, Panneer Selvam SR: Pathophysiology and management of airway trauma. Trends Anaesth Crit Care. 2013, 3: 216-219.[cardiothoracicsurgery.biomedcentral.com]

Prevention

  • الصفحة 348 - Hospital-acquired pneumonia in adults: diagnosis, assessment of severity, initial antimicrobial therapy, and preventive strategies. ‏ الصفحة 361 - Pepe PE, et al.[books.google.com]
  • Thus, early surgical intervention is essential to prevent long-term complications of this injury. Ninety percent of these injuries if primarily repaired heal without any sequelae [2-5].[ctsnet.org]
  • Considering that the patient had multiple organ injuries and was in a state of unconsciousness, he was given orotracheal intubation in order to protect airway and prevent asphyxia.[omicsonline.org]
  • Definitive management Surgery The rational for surgery can be summarized in: a. closing of the airway defect to improve ventilation, b. preventing mediastinal spillage and infection and c. avoiding spontaneous healing complications which can lead to airway[cardiothoracicsurgery.biomedcentral.com]

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