Blunt tracheal transection and long tear in posterior membranous trachea

Ishibashi, Hiroyuki; Ohta, Shinichiro; Hirose, M; Akimoto, Takehide

doi:10.1016/j.ejcts.2006.09.009

Cited by 13 publications

(18 citation statements)

References 6 publications

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“…[1] Trakeobronşiyal yaralanmalar ise travma sonrası görülen nadir (%1-4), fakat hayatı tehdit eden patolojilerdir. [1,2] Sıklıkla künt travmalar sonucu görülseler de penetran veya ateşli silah yaralanmaları, eksplorasyon yaralanmaları ve iyatrojenik yaralanmalar nedeni ile de oluşabilir. [3,4] Trakeobronşiyal yaralanmalar, membranöz yüzde basit bir yır-tıktan, tam ayrılmaya kadar değişen derece ve bölge-lerde enine, uzunlamasına ve kompleks olarak görü-lebilmektedirler.…”

Section: Resultsunclassified

“…[2] Toraks travmalı olgularda trakeobronşiyal travma için spesifik bronkoskopi endikasyonları; hemoptizi, pnömomediastinum, servikal amfizem ve tüp torakostomi ile drenaja rağmen devam eden pnömotorakstır. [7] Şüpheli olgularda BT çe-kilmesi, zaman ve olanaklar elverişli ise üç boyutlu rekonstrüksiyon ve sanal bronkoskopi yapılması tanıda yardımcı olmaktadır.…”

Section: şEkilunclassified

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Tracheobronchial injuries

AYDEMİR¹

2011

Ulus Travma Acil Cerrahi Derg

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AMAÇBu çalışmada, trakeobronşiyal yaralanmaların tanı ve tedavisinde kullanılan yöntemleri araştırdık ve literatürle karşı-laştırmayı amaçladık. GEREÇ VE YÖNTEMKliniğimizde 2003-2008 yılları arasında trakeobronşiyal yaralanma nedeni ile ameliyat edilen 9 olgu (7 erkek, 2 kadın) çalışmaya dahil edildi. Travma sonrası trakeobronşi-yal yaralanma nedeni ile ameliyat edilen 7 olgu ile entü-basyon sonrası trakeal yaralanma görülen 2 olgu incelendi. Olgular, yaş, cinsiyet, travma tipi, klinik bulgular, yaralanma bölgesi, uygulanan girişim ve sonuçları açısından değerlendirildi. BULGULARYaralanma 6 olguda künt travma, 1 olguda penetran travma sonucu gerçekleşirken, 2 olguda ise iyatrojenikti. Yaralanma 5 olguda trakeal, 4 olguda ise bronşiyal seviyede idi. Bir olguya üst bilobektomi, bir olguya trakeal rezeksiyon ve ucuca anastamoz, 3 olguya uçuca anastomoz ve 4 olguya ise primer tamir yapıldı. Bir olgu ameliyat sırasında, bir olgu ise ameliyat sonrası erken dönemde kaybedildi. SONUÇTrakeobronşiyal yaralanmalarda erken tanı önemlidir. Yaralanmanın yerinin ve şeklini belirlenmesi için kullanılan en önemli tanı aracı bronkoskopidir. Tedavide rezeksiyondan mümkün olduğunca kaçınılmalı ve primer onarım tercih edilmelidir.

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Section: Resultsunclassified

Section: şEkilunclassified

Tracheobronchial injuries

AYDEMİR¹

2011

Ulus Travma Acil Cerrahi Derg

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“…Treatment strategy depends on the clinical presentation and overall condition of the patient, and the etiology, location and size of the lesion [7,13]. Prognosis is mostly related to the underlying disease rather than the tracheal injury [3,13]. There is a consensus on the criteria for conservative treatment; the criteria for conservative treatment are stable vital signs, spontaneous breathing or no difficulty in ventilation while intubated or no respiratory distress after extubation, no evidence of esophageal injury, nonprogressive pneumomediastinum or subcutaneous emphysema and no signs of sepsis [4,5,13].…”

Section: Discussionmentioning

confidence: 99%

“…Anatomical, mechanical or personal factors may be responsible in the development of an ITR [5,9]. The etiological factors contributing to these injuries are, emergency intubations with stress situations, repeated attempts at intubation (difficult intubation), inadequate tube size (oversized tube), inappropriate intubation technique, overdistention or rupture of the cuff, malposition of the tube, strong cough while the expiration valve is closed, repositioning of the tube with the inflated cuff, and head and neck movements in intubated patients [1,3,5,10,11]. Anatomic abnormalities of the trachea, aortic aneurysm, disease causing distortion of the trachea, lung and mediastinum tumors, chronic obstructive pulmonary disease, inflammatory lesions of the trachea, chronic use of steroids, advanced age (over 50 years) and gender (being a woman) are the other reported risk factors [5,9].…”

Section: Discussionmentioning

confidence: 99%

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Iatrogenic Tracheal Ruptures: Review of the Literature and Personal Experience on 11 Cases

Aydemir¹,

Çelık²,

Uncu³

et al. 2013

OJTS

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Objective: Iatrogenic tracheal rupture is a rare, but life-threatening complication of orotracheal intubation. In this retrospective study, etiology, and diagnostic and therapeutic approaches for iatrogenic tracheal ruptures were reviewed. Method: Eleven patients (6 males and 5 females) were diagnosed and treated for iatrogenic tracheal rupture in our clinic. The laceration occurred after orotracheal intubation in 7 cases, and during percutaneous tracheostomy and emergency tracheostomy in the other four cases, respectively. Diagnosis was made during thoracic surgery in 5 cases. The remaining cases were diagnosed in the post-operative period; the most common symptoms were mediastinal and subcutenous emphysema and pneumothorax. Results: The diagnosis was confirmed by bronchoscopy in all cases. The lacerations were longitudinal, 1 -7 cm in length and were located in the distal membranous trachea. While ruptures detected intraoperatively were repaired during the surgery, the others were treated conservatively. No mortality was observed among cases treated surgically. However, three of the cases treated conservatively died (50%), and the cause of death was the underlying disease requiring intubation. Conclusion: We are in the opinion that primary disease is a determinant of patient outcome. Except cases identified during surgery, emergency surgical interventions should be preferred in patients, in whom ventilation cannot be achieved. On the other hand, bronchoscopic fibrin glue instillation should additively be applied to conservative treatment of tracheal lacerations.

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Complete cervical tracheal transection due to blunt trauma

Nitta

Hamano

Kamijo

et al. 2016

Acute Medicine & Surgery

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Case: A 31-year-old man was caught up in the rotor of a snow-removing truck. He was diagnosed with tension pneumothorax and managed with tube thoracostomy in the ambulance. But he was left with respiratory discomfort. Computed tomography scan suggested the diagnosis of complete cervical tracheal transection.Outcome: The endotracheal tube was advanced distal to the transection site under bronchoscopic guidance, which stabilized the patient's cardiopulmonary condition. The tracheal injury healed well after emergent surgical repair. Conclusion:Complete cervical tracheal transection is rare and requires a high index of suspicion for timely diagnosis. It is important to secure the airway, which can be done by fiberoptic bronchoscopy.

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Blunt tracheal transection and long tear in posterior membranous trachea

Cited by 13 publications

References 6 publications

Tracheobronchial injuries

Tracheobronchial injuries

Iatrogenic Tracheal Ruptures: Review of the Literature and Personal Experience on 11 Cases

Complete cervical tracheal transection due to blunt trauma

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