Nitta Kenichi, Hamano Yujiro, Kamijo Hiroshi, Oishi So, Ichikawa Michitaro, Takayama Hiroshi, Mochizuki Katsunori, Agatsuma Hiroyuki, Imamura Hiroshi
Department of Emergency and Critical Care Medicine Shinshu University School of Medicine Nagano Japan.
Department of Surgery Shinshu University School of Medicine Nagano Japan.
Acute Med Surg. 2016 Mar 28;3(4):376-379. doi: 10.1002/ams2.184. eCollection 2016 Oct.
A 31-year-old man was caught up in the rotor of a snow-removing truck. He was diagnosed with tension pneumothorax and managed with tube thoracostomy in the ambulance. But he was left with respiratory discomfort. Computed tomography scan suggested the diagnosis of complete cervical tracheal transection.
The endotracheal tube was advanced distal to the transection site under bronchoscopic guidance, which stabilized the patient's cardiopulmonary condition. The tracheal injury healed well after emergent surgical repair.
Complete cervical tracheal transection is rare and requires a high index of suspicion for timely diagnosis. It is important to secure the airway, which can be done by fiberoptic bronchoscopy.
一名31岁男子被卷入扫雪车的旋转部件中。他被诊断为张力性气胸，并在救护车上接受了胸腔闭式引流术治疗。但他仍有呼吸不适。计算机断层扫描提示诊断为完全性颈段气管横断伤。
在支气管镜引导下，将气管导管推进至横断部位远端，稳定了患者的心肺状况。紧急手术修复后，气管损伤愈合良好。
完全性颈段气管横断伤罕见，需要高度怀疑以实现及时诊断。确保气道安全很重要，这可以通过纤维支气管镜检查来完成。
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