Pswarayi Rudo Mutsa Vanessa, Kerola Anna Katariina
Department of Trauma Surgery, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Orthopaedics and Traumatology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
J Trauma Inj. 2023 Dec;36(4):416-420. doi: 10.20408/jti.2023.0036. Epub 2023 Nov 30.
Blunt intrathoracic tracheal injuries are rare, even among blunt chest trauma patients. An early diagnosis based on a high index of suspicion allows for timely surgical management of potentially fatal airway trauma, thereby improving overall outcomes. Diagnosing these injuries can be difficult due to their nonspecific clinical features and the occasional difficulty in radiologic diagnosis. If a patient exhibits respiratory compromise with difficult ventilation and poor lung expansion, despite the insertion and management of an intercostal drain following high-energy blunt trauma, there should be a heightened suspicion of potential airway trauma. The aim of primary repair is to restore airway integrity and to minimize the loss of pulmonary parenchyma function. This case report discusses the rare clinical presentation of a patient with blunt trauma to the intrathoracic airway, the surgical management thereof, and his overall outcome. Although blunt traumatic injuries of the trachea are extremely rare and often fatal, early surgical intervention can potentially reduce the risk of mortality.
钝性胸段气管损伤很少见，即使在钝性胸部创伤患者中也是如此。基于高度怀疑指数的早期诊断能够对潜在致命的气道创伤进行及时的手术治疗，从而改善总体预后。由于这些损伤的临床特征不具特异性，且放射学诊断偶尔存在困难，因此诊断这些损伤可能具有挑战性。如果患者在高能钝性创伤后，尽管插入并管理了肋间引流管，但仍出现呼吸功能不全、通气困难和肺扩张不良，应高度怀疑存在潜在的气道创伤。一期修复的目的是恢复气道完整性，并尽量减少肺实质功能的丧失。本病例报告讨论了一名胸段气道钝性创伤患者的罕见临床表现、手术治疗及其总体预后。虽然气管钝性创伤极其罕见且往往致命，但早期手术干预有可能降低死亡风险。
