Acer-Demir Tugba, Arslan Esra Elif
Department of Paediatric Surgery, Baskent University, Ankara, Turkey.
Afr J Paediatr Surg. 2021 Apr-Jun;18(2):94-96. doi: 10.4103/ajps.AJPS_13_20.
Up to date, only five cases of iatrogenic tracheal rupture during rigid bronchoscopy have been reported in children. Herein, we report the first case who has recovered with spontaneous respiration without intubation. Rigid bronchoscopy of a 19-month-old girl revealed a foreign body at the right main bronchus. While the bronchoscope was being withdrawn, we identified a 0.5-cm longitudinal mucosal laceration along the right wall of the membranous trachea. As her spontaneous respiration was adequate, she was treated conservatively. For the treatment of tracheal lacerations, while early surgical repair has traditionally been acceptable, evidence supporting conservative treatment is increasing, particularly in paediatric cases. If spontaneous respiration is sufficient, bridging the laceration with an endotracheal tube may not be required.
迄今为止，儿童硬质支气管镜检查期间医源性气管破裂仅报告过5例。在此，我们报告首例未经插管而恢复自主呼吸的病例。一名19个月大女童的硬质支气管镜检查显示右主支气管有异物。在拔出支气管镜时，我们发现沿膜性气管右壁有一处0.5厘米长的纵向粘膜撕裂伤。由于她的自主呼吸良好，故采取保守治疗。对于气管撕裂伤的治疗，虽然传统上早期手术修复是可行的，但支持保守治疗的证据越来越多，尤其是在儿科病例中。如果自主呼吸充足，可能无需用气管内插管来弥合撕裂伤。
