ABSTRACT
Tracheal rupture is an infrequent complication with high morbidity and mortality, of multifactorial etiology, being orotracheal intubation its main cause. Spontaneous tracheal rupture usually occurs after severe coughing and/or vomiting over a weakened trachea. The diagnosis is non-specific, based on highly suggestive signs and symptoms such as subcutaneous emphysema, pneumomediastinum and respiratory distress, and its confirmation requires the performance of a bronchoscopy. The location and extent of the rupture determines the clinic. This implies the importance of an early diagnosis to avoid a poor prognosis. We present the case of an elderly male patient with a spontaneous tracheal rupture without apparent cause
La rotura traqueal es una complicación infrecuente de etiología multifactorial, con una elevada morbimortalidad, la intubación orotraqueal es su principal causa. La rotura traqueal espontánea suele producirse luego de toser o presentar vómitos intensos, sobre una tráquea debilitada. El diagnóstico es inespecífico, se basa en signos y síntomas altamente sugestivos como enfisema subcutáneo, neumomediastínico y dificultad respiratoria y su confirmación exige la realización de una broncoscopia. La localización y extensión de la rotura determinan la clínica. Esto implica la importancia del diagnóstico precoz para evitar un pronóstico infausto. Se presenta el caso de un paciente varón, de edad avanzada. con una rotura espontánea traqueal sin causa aparente
Subject(s)
Humans , Male , Aged, 80 and over , Trachea , Tracheal Diseases , Neck Injuries , Dyspnea , Rupture, SpontaneousABSTRACT
Antecedentes: La rotura traqueal completa y la lesión de conducto torácico representan complicaciones raras del trauma torácico cerrado. Método: Se presenta el caso de un paciente con rotura completa de la tráquea asociada a rotura del conducto torácico que fue operado en el Hospital del Trabajador. Discusión y conclusiones: La identificación y el manejo oportuno de estas lesiones disminuyen la morbimortalidad asociada a trauma.
Background: Tracheal rupture and thoracic duct lesion are rare complications of blunt thoracic trauma. Method: We present in this article the case of a patient with complete tracheal rupture and thoracic duct lesion treated in Hospital del Trabajador. Discussion and conclusions: Early identification and prompt management of this conditions reduce morbimortality associated with trauma.
Subject(s)
Humans , Male , Adult , Young Adult , Thoracic Injuries/complications , Trachea/surgery , RuptureABSTRACT
Abstract Tracheobronchial rupture is a rare but potentially life-threatening complication commonly caused by neck and chest trauma. Iatrogenic tracheobronchial rupture can be caused by intubation, tracheostomy, bronchoscopy but also linked to pre-existing primary diseases. Paratracheal air cysts, infrequently described in literature, seem to be associated with obstructive lung disease and weaknesses in right posterior lateral wall of the trachea. We report a case of a paratracheal air cyst rupture in a previous healthy patient.
Resumo A ruptura traqueobrônquica (RTB) é uma complicação rara, mas potencialmente fatal, comumente causada por trauma de pescoço e tórax. A RTB iatrogênica pode ser causada por intubação, traqueostomia, broncoscopia, mas também pode estar relacionada a doenças primárias preexistentes. Os cistos aéreos paratraqueais, raramente descritos na literatura, parecem estar associados à doença pulmonar obstrutiva e fraqueza da parede posterolateral direita da traqueia. Relatamos o caso de uma ruptura de cisto aéreo paratraqueal em paciente previamente saudável.
Subject(s)
Humans , Male , Rupture/diagnosis , Tracheal Diseases/diagnosis , Cysts/diagnosis , Rupture/pathology , Trachea/injuries , Tracheal Diseases/pathology , Cysts/pathology , Diagnosis, Differential , Middle AgedABSTRACT
Tracheobronchial ruptures (TBR) rarely complicate surgical procedures under general anesthesia. Seemingly uneventful intubations can result in injury to the trachea, which often manifests as hemoptysis and subcutaneous emphysema. We present 2 patients with postintubation TBR who were treated surgically and discuss considerations in the management of this potentially lethal injury.
Subject(s)
Humans , Anesthesia, General , Hemoptysis , Intubation , Intubation, Intratracheal , Rupture , Subcutaneous Emphysema , TracheaABSTRACT
A case of extensive pneumomediastinum and subcutaneous emphysema is presented, after endotracheal intubation with a metallic endotracheal tube during laser epiglottectomy. A 69 year old woman had a laser tube intubation-related tracheal injury. The patient was managed with intubation and chest tube insertion as well as antibiotic treatment. The patient made a full and uncomplicated recovery and was discharged 10 days after the original injury. Aggressive surgical repair for such injuries is not always mandatory. In the absence of infectious complications, a conservative approach is an option for lesions 3 cm above the carina where it is possible to inflate a cuff. Urgent chest CT scanning subsequently can confirm extensive mediastinal and subcutaneous emphysema and probable tracheal laceration. The use of a laser tube during laser laryngeal microsurgery requires meticulous care.
Subject(s)
Female , Humans , Chest Tubes , Intubation , Intubation, Intratracheal , Lacerations , Laser Therapy , Mediastinal Emphysema , Microsurgery , Rupture , Subcutaneous Emphysema , ThoraxABSTRACT
Objective:To study the clinical manifestations and treatments of closed injuries of the cervical trachea.Method:We carried out a retrospective study of the clinical manifestations, diagnosis and treatment of patients with closed injuries of the cervical trachea that have been treated in our hospital over the last ten years. We analyzed commonly occurring clinical problems, key points of surgical treatment, and postoperative recovery. Fourty-one patients with acute closed injuries of the cervical trachea underwent emergency tracheotomy or anesthesia orotracheal intubation and surgical repair of the trachea within 24 to 48 hours. Twenty six patients had their tracheotomy tubes extubated after surgery and had their anesthesia orotracheal tubes extubated within 48 hours postoperatively; tracheotomy tubes remained in the airway in 15 patients postoperatively, and of them, 12 had extubation successfully in 2 weeks postoperatively, while the remaining 3 were left intubated due to laryngotracheal stenosis. Among the 3, 2 underwent further surgical repair and recovery, and 1 had a stent inserted.Result:Twenty-eight patients fully recovered postoperatively. Ten patients mostly recovered postoperatively exception for hoarseness, and their fundamental phonation function recovered within 2 to 3 months but with poor movement of the vocal cords. The breathing and swallowing function of the other 3 patients recovered after the surgery, but they suffer from hoarseness.Conclusion:In the treatment of closed disruption of the cervical trachea, prompt diagnosis and timely surgical repair of the structure and function of the trachea are key to saving the patients' lives and avoiding tracheal stenoses.
ABSTRACT
Tracheal rupture is a rare complication of tracheal intubation, but may result in pneumothorax, mediastinal emphysema, subcutaneous emphysema and other serious outcomes. Risk factors associated with tracheobronchial rupture include multiple vigorous attempts at intubation, inexperienced operator, intubating stylets, tracheal abnormalities, overdistension of tracheal or bronchial cuff, repositioning of tube without deflating the cuff, chronic obstructive airway disease and vigorous coughing while being intubated. We report a case of tracheal rupture after using single lumen endotracheal tube. A 41-year-old, 53 kg, female was operated for a repair of anterior cruciate ligament under general anesthesia in other hospital. Two hours later after the end of operation, facial swelling, dyspnea and chest pain developed. Chest computed tomography showed mediastinal emphysema. She was transferred to our hospital and bronchoscopy showed a rupture at posterior part of membranous portion 2 cm proximal to carina. Trachea was repaired and she was discharged from the hospital without complication.
Subject(s)
Adult , Female , Humans , Anesthesia, General , Anterior Cruciate Ligament , Bronchoscopy , Chest Pain , Cough , Dyspnea , Emphysema , Intubation , Mediastinal Emphysema , Pneumothorax , Pulmonary Disease, Chronic Obstructive , Risk Factors , Rupture , Subcutaneous Emphysema , Thorax , TracheaABSTRACT
Tracheobronchial rupture is considered to be a life-threatening condition and most commonly occurs after blunt trauma to the neck or chest. However, single- and double-lumen endotracheal tubes can cause serious airway injury. The recognition of this complication and a knowledge of the possible contributory factors is critical, because failure to do so could result in lethal events. We report the case of a 63-year-old male patient who developed pneumomediastinum three days after routine orotracheal intubation.
Subject(s)
Humans , Male , Middle Aged , Intubation , Intubation, Intratracheal , Mediastinal Emphysema , Neck , Rupture , Subcutaneous Emphysema , ThoraxABSTRACT
Tracheobronchial rupture associated with esophageal rupture due to blunt chest trauma is very rare. However, increasing number of thoracic inj uries have been reported during the recent years; This trend could be attributed to an increase in high-speed traffic accidents, and also to the better care for patients suffering from trauma. We report two cases of long tracheal disruption associated with esophageal rupture as a result of a nonpenetrating thoracic trauma. One patient who was transferred from another hospital after failed tracheoesophageal reconstruction received secondary reconstructive surgery but expired, and the other patient survived without any serious complications with reconstructive surgery.
Subject(s)
Humans , Accidents, Traffic , Plastic Surgery Procedures , Rupture , ThoraxABSTRACT
Tracheobronchial rupture is one of the less-common injuries associated with blunt chest trauma. The diagnosis of tracheobronchial rupture is not easy, but failure to diagnosis may lead to death or long-term disability. Early diagnosis and appropriate management can reduce the mortality and morbidity. Bronchoscopy is the diagnostic method of choice for patients with tracheobronchial rupture. We report a case of tracheal rupture after blunt chest trauma. A 40-year-old man was transferred to our hospital for dyspnea after blunt chest trauma. He was promptly diagnosed as tracheal rupture by fiberoptic bronchoscopy and chest computed tomogram. He was successfully managed by thoracotomy and primary repair.
Subject(s)
Adult , Humans , Bronchoscopy , Diagnosis , Dyspnea , Early Diagnosis , Mortality , Rupture , Thoracotomy , ThoraxABSTRACT
Tracheobronchial rupture is one of the less-common injuries associated with blunt chest trauma. The diagnosis of tracheobronchial rupture is not easy, but failure to diagnosis may lead to death or long-term disability. Early diagnosis and appropriate management can reduce the mortality and morbidity. Bronchoscopy is the diagnostic method of choice for patients with tracheobronchial rupture. We report a case of tracheal rupture after blunt chest trauma. A 40-year-old man was transferred to our hospital for dyspnea after blunt chest trauma. He was promptly diagnosed as tracheal rupture by fiberoptic bronchoscopy and chest computed tomogram. He was successfully managed by thoracotomy and primary repair.