Ershadi Reza, Hajipour Asghar, Vakili Mohamadrahim
Department of Thoracic Surgery, Valiasr Hospital, Tehran University of Medical Science, Tehran, Iran.
J Surg Case Rep. 2017 Jun 20;2017(6):rjx111. doi: 10.1093/jscr/rjx111. eCollection 2017 Jun.
Laryngotracheal injuries are relatively rare but their mortality rate is fairly high. Complete disruption of trachea is extremely rare and a systematic approach is needed for early diagnosis and favourable outcome. The patients symptoms and physical signs do not necessarily correlate with the severity of the injuries and this case report highlights it. This is a case report of 25-year-old man who arrived to the emergency department 8 h after a motor accident in which a rope was wrapped around his neck. Because of the good general and respiratory condition of the patient on admission, the pathognomonic signs of laryngeal injury were not noticed. A computed tomographic scan showed distortion of cricotracheal framework. Flexible bronchoscopy showed cricotracheal transaction. Immediately, the endotracheal tube was advanced distal to the transection site under bronchoscopic guide and then after neck exploration primary end-to-end cricotracheal anastomosis was performed.
喉气管损伤相对少见，但其死亡率相当高。气管完全断裂极为罕见，早期诊断及获得良好预后需要系统的处理方法。患者的症状和体征不一定与损伤的严重程度相关，本病例报告突出了这一点。这是一例25岁男性的病例报告，该患者在一场颈部被绳索缠绕的车祸后8小时到达急诊科。由于患者入院时一般情况及呼吸状况良好，未注意到喉损伤的特征性体征。计算机断层扫描显示环状气管结构扭曲。纤维支气管镜检查显示环状气管横断。随即在支气管镜引导下将气管导管推进至横断部位远端，然后经颈部探查后进行了一期环状气管端端吻合术。
