Isolated Through-and-Through Tracheal Injury Caused by Gunshot Wound to the Chest Successfully Managed with Primary Repair and Buttressing Intercostal Muscle Flap

Abstract

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Penetrating firearm tracheal injury with cardiac arrest due to tension pneumopericardium

“…6 A 2018 case report described a patient with tracheal injury from a gunshot wound presenting with respiratory compromise who was able to receive CT angiogram imaging prior to transport to the operating room, which delineated the exact location of the injury, providing valuable information for operative planning. 7 CT imaging prior to the operating room proved invaluable in our case as it increased the suspicion of tension pneumomediastinum from a tracheal injury as the cause of hemodynamic compromise. Consequently, we were able to immediately address the patient deterioration due to pneumo tamponade via a midline sternotomy rather than a clam shell or left anterior thoracotomy, neither of which would not have allowed appropriate exposure of the tracheal injury.…”

Double Intercostal Muscle Flap to Repair an Extensive Esophageal Wall Defect

“…Pedicled IMF has been used to buttress the bronchial stumps after pulmonary resection especially in patients at high risk of breakdown, as well as for coverage of esophageal-gastric anastomosis and repairs of esophageal fistulas. 1,2 In children, IMF has been occasionally used to repair and/or to reinforce the closure of congenital and acquired tracheoesophageal and diaphragmatic defects. The scattered reports and several large series revealed substantial evidence on the benefits of prophylactic and therapeutic IMF.…”