Bullet wounds of the trachea

Symbas, Panagiotis N.; Hatcher, Charles R.; Vlasis, S.E.

doi:10.1016/s0022-5223(19)37302-7

Cited by 31 publications

(14 citation statements)

References 5 publications

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“…In patients operated on for penetrating injuries, the mortality is 6% to 18% [7,8]. Of 17 survivors of penetrating tracheal trauma in one series, 15recovered completely [8].…”

Section: Discussionmentioning

confidence: 99%

“…The most common symptoms are dyspnea and respiratory distress (76-100%) and half of those with cervical injuries present with hoarseness and/or dysphonia, often with anterior neck swelling and bruising (Figure 1) [20][21][22][23][24]. Air escaping from a neck wound occurs in approximately 60% of patients with cervical penetrating trauma to the trachea [1,7]. If the cervical air leak ceases after intubation, this confirms the diagnosis.…”

Section: Diagnosis In the Acute Settingmentioning

confidence: 92%

“…Less than 1% of patients with penetrating chest injuries suffer tracheobronchial injury [5,6]. Overall, the incidence of penetrating tracheobronchial trauma constitutes 1% to 2% of thoracic trauma admissions in major trauma centers [5][6][7][8].…”

Section: Incidencementioning

confidence: 99%

“…Of penetrating intrathoracic injuries, associated injuries included esophageal (11%); major vascular injury (18%); cardiac injury (5%); spinal cord injury (7%); and intra-abdominal injuries (18%) [20]. Several other series have shown an overall incidence of associated major injuries with penetrating tracheobronchial trauma to be in the range of 50% to 80%, most of these being esophageal and vascular injuries, followed by spinal cord, pulmonary, and intra-abdominal injuries [6,7,11,18,21,22]. The majority of associated injuries in the cervical area can be managed concurrently with repair of the airway, while intrathoracic injuries often require a combined approach, with the most immediately lethal injuries taking precedence.…”

Section: Associated Injuriesmentioning

confidence: 99%

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Tracheobronchial Trauma

Peters¹,

Thunell²,

Karmy‐Jones³

2015

CRMR

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Tracheobronchial injuries are uncommon, occurring in less than 1% of all patients following injury. However, the incidence is higher in specific subsets, notably up to 8% following penetrating neck injury and up to 2% following high energy blunt chest and/ or focal cervical injury. In the majority of cases tracheobronchial injury presents as immediately life threatening injuries, but in up to 1/5 of cases they manifest in a more occult fashion with late onset of hemoptysis, recurrent pneumonia and/or "asthma." Diagnosis often requires a high degree of clinical suspicion. Initial management is based on immediate securing of the airway, which often requires bronchoscopic assistance. Subsequent repair must take into account the severity of associated injuries and exact location and degree of airway disruption. Repair strategy must include a coordinated plan with anesthesia, including possible cross field ventilation. The majorities of patients who survive to undergo treatment do well, but must be followed for late complications, notably stricture formation.

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“…In patients operated on for penetrating injuries, the mortality is 6% to 18% [7,8]. Of 17 survivors of penetrating tracheal trauma in one series, 15recovered completely [8].…”

Section: Discussionmentioning

confidence: 99%

Section: Diagnosis In the Acute Settingmentioning

confidence: 92%

Section: Incidencementioning

confidence: 99%

Section: Associated Injuriesmentioning

confidence: 99%

See 2 more Smart Citations

Tracheobronchial Trauma

Peters¹,

Thunell²,

Karmy‐Jones³

2015

CRMR

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“…The urgency to identify and treat tracheal injuries is well documented; however a standardized technique for removal of foreign bodies during an emergency situation is not established. The most common signs of airway injury are subcutaneous emphysema pneumothorax and hemoptysis [ 6 , 7 ]. A pathognomonic sign of airway laceration is air escaping from a penetrating wound in the neck [ 7 - 10 ].…”

Section: Discussionmentioning

confidence: 99%

Bronchoscopic retrieval of a bullet using a Dormia basket: a case report

2014

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IntroductionPenetrating bullet injury to the trachea is a rarity, and therefore standardized procedure for injury management and foreign body removal has not been established. This is a case report describing retrieval of a bullet from the bronchus intermedius using flexible bronchoscopy and a Dormia basket.Case presentationA 19-year-old African American woman presented with a gunshot wound to her right neck just lateral to the sternal head of the sternocleidomastoid muscle and just superior to the clavicle. Imaging showed a bullet lodged within her right bronchus with no evidence of vascular injury. Fiberoptic flexible bronchoscopy in combination with biopsy forceps and a Dormia basket were used for bullet removal.ConclusionsRemoval of foreign bodies from the airway is essential in order to avoid complications such as tracheal stenosis, pneumonia, bronchiectasis and foreign body migration. To the best of our knowledge, this case is one of only several cases reporting the use of flexible bronchoscopy for bullet removal, and this is the only case to describe the use of a Dormia basket. This case demonstrates bronchoscopy as a safe and effective means of minimally invasive removal of a bullet fragment from the bronchus in a trauma setting.

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Management of penetrating laryngotracheal injuries

et al. 1995

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Mortality can be minimized by aggressive airway control. Endotracheal intubation can be accomplished safely in selected patients with penetrating laryngotracheal injuries. Digestive-tract injuries can often clinically occult and contribute significantly to morbidity and mortality; therefore, early evaluation of the esophagus is vital. Simple repair of laryngotracheal and digestive-tract injuries can be performed safely with good results. In patients with minor injuries, tracheostomy does not appear to be mandatory.

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Bullet wounds of the trachea

Cited by 31 publications

References 5 publications

Tracheobronchial Trauma

Tracheobronchial Trauma

Bronchoscopic retrieval of a bullet using a Dormia basket: a case report

Management of penetrating laryngotracheal injuries

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