Asai Y, Kaneko M, Imaizumi H, Kobayashi K, Hamamoto M, Takada R, Asakura K
Department of Traumatology and Critical Care Medicine, Sapporo Medical University School of Medicine, Japan.
Surg Today. 1996;26(5):353-6. doi: 10.1007/BF00311606.
We report herein the cases of two patients who suffered tracheal disruption, both of whom underwent successful surgical treatment. The first patient was a 48-year-old truck driver who suffered severe dyspnea after jamming his neck in a truck door. An endotracheal tube was unable to be inserted due to bleeding and thus, an emergency tracheostomy was performed. On admission massive subcutaneous emphysema was noted in the neck and anterior chest, and tracheal disruption was confirmed by a lateral neck X-ray, computed tomography (CT), and fiberscopy. An emergency end-to-end anastomosis of the trachea with insertion of a T-type silicon tube into the lower trachea was performed. The second patient was a 36-year-old man who suffered severe dyspnea after having his neck caught in a chain while driving a motorcycle. On admission, marked subcutaneous emphysema in the neck and paradoxical movement of the trachea were noted. Tracheal disruption was confirmed by a lateral neck X-ray and CT, and a similar operation to that of the first patient was performed. This type of injury is rare; however, lateral neck X-ray, CT, and fiberscopy proved extremely useful for making an accurate diagnosis following which successful emergency surgery was able to be performed, achieving good long-term results.
我们在此报告两例气管断裂患者的病例，两名患者均接受了成功的手术治疗。首例患者是一名48岁的卡车司机，其颈部被卡车车门卡住后出现严重呼吸困难。由于出血，无法插入气管内插管，因此进行了紧急气管切开术。入院时，颈部和前胸可见大量皮下气肿，经颈部侧位X线、计算机断层扫描（CT）和纤维内镜检查确诊为气管断裂。进行了紧急气管端端吻合术，并在下段气管插入T型硅胶管。第二例患者是一名36岁男性，骑摩托车时颈部被链条卡住后出现严重呼吸困难。入院时，可见颈部明显皮下气肿和气管反常运动。经颈部侧位X线和CT检查确诊为气管断裂，并进行了与首例患者类似的手术。这种损伤很罕见；然而，颈部侧位X线、CT和纤维内镜检查对于准确诊断非常有用，在此基础上能够成功进行紧急手术，并取得良好的长期效果。
