Massive Tracheal Rupture in Blunt Chest Trauma: Reconstruction with Autologous Pericardium

Abstract

Tracheal blunt trauma is a rare entity in the pediatric population due to its specific anatomy and biomechanical characteristics. The resulting injury can compromise the airway and quickly become lethal. Early bronchoscopy is essential to diagnose and classify the damage and severity of the lesion to the airway, as well as for postoperative follow-up. In addition to an early diagnosis, it is essential to manage a successful therapeutic intervention, often by surgery.Tracheal reconstruction is a challenging procedure for thoracic surgeons. When direct closure is not possible, a circumferential resection and endto-end anastomosis remains to be a highly effective treatment for a tracheal reconstruction. There are situations where this procedure carries a high risk, so, a partial resection and the use of autologous tissue graft for the repair of the tracheal defect will be needed. Several studies have described and established the feasibility of using pericardium and cardiopulmonary bypass for tracheal repair defects in the pediatric population.We present a case of blunt chest trauma in a pediatric patient with massive tracheal laceration, repaired with an autologous pericardial patch, using extracorporeal circulation with a beating heart.