Management of Complete Tracheal Disruption after a Fall

ABSTRACT

A complete tracheal rupture due to blunt trauma is rare, and a high proportion of patients with this injury die prior to arrival at medical centers. Early diagnosis and prompt management is essential in order to reduce morbidity and mortality. A 38-year-old woman visited the emergency department after a fall from the 4th floor of a building. We confirmed that a complete tracheal disruption 4 cm above the carina by chest CT. We could not insert an endotracheal tube because the distal stump of the trachea was separated by 4 cm from the proximal stump, so we used percutaneous cardiopulmonary bypass for the prevention of hypoxia during the initial operative procedures. We performed resections and reconstruction of the injured trachea. Fourteen days after the operation we confirmed normal healing of the trachea with bronchoscopy. One year after the operation, the patient is healthy with no tracheal problems.