Background: Tracheobronchial injury in children is rare but can be highly fatal in severe cases. Therefore, prompt diagnosis and treatment are required. The appropriate treatment method depends on the extent and severity of the injury.
Case Presentation: An 8-year-old girl fell from the fifth floor and was transported to a local hospital. She had a tracheobronchial injury, went into cardiopulmonary arrest during transportation to our hospital. She was revived with cardiopulmonary resuscitation, and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was commenced. Subsequently, we performed tracheobronchial reconstruction by inverted Barclay's method for tracheobronchial injury. She was switched from VA-ECMO to venovenous (VV)-ECMO 4 days postoperatively, and VV-ECMO was eventually discontinued 27 days after the surgery. The patient was awake and weaned off the ventilator on postoperative day 58. She was discharged 97 days after the surgery.
Conclusions: Tracheobronchial reconstruction by inverted Barclay's method is the preferred surgical technique when other reconstruction techniques are expected to cause excessive tension on the anastomosis of the right main bronchus.
An acute injury of the tracheobronchial system is a rare but potentially life-threatening condition that can be caused by medical procedures. Diagnosis requires a thorough evaluation of the patient's medical history, physical examination, and imaging tests. Identification of a tracheal rupture in patients under sedation or general anesthesia may be difficult, and a strong clinical suspicion is essential.
- Tracheobronchial injuries are serious and often misdiagnosed; larger injuries are harder to heal, leading to a variety of treatment options.
- A case of a 63-year-old man with a severe 4-cm tracheobronchial tear post-surgery was effectively treated with conservative measures including oxygen, pain management, antibiotics, and nutritional support.
- The patient healed completely in four weeks with no complications, highlighting that conservative treatment can be a successful approach for significant tracheal injuries, especially in older patients with other health issues.
Background: Tracheobronchial injury (TBI) is the subsuming term to describe rare and mostly traumatic damage to the tracheobronchial tree. Prehospital mortality is significant. TBI patients may face delayed diagnosis, challenging perioperative care, and prolonged recovery.
Bronchial rupture should be considered in cases of significant air leaks from intercostal drain tubes after major chest trauma, as indicated by X-rays and CT scans.
A case study of a 15-year-old boy involved in a car accident showed severe chest injuries, including rib fractures and pneumothorax, but no clear signs of bronchial rupture were found.
Mechanical ventilation parameters indicated low pressures and tidal volume, which may signal bronchial rupture as a critical complication of blunt chest trauma.
* It's crucial to assess the tracheobronchial tree with a flexible bronchoscope in children with suspected laryngotracheal injuries to avoid worsening the trauma through blind intubation.
* The report focuses on a middle childhood patient who experienced a complete tracheal transection due to blunt laryngotracheal trauma, highlighting the importance of thorough airway management.
