Tracheobronchial injury diagnosed by computed tomography scan: a case report

Cosper, Graham H.; Dassinger, Melvin S.

doi:10.1016/j.jpedsurg.2008.11.052

Cited by 4 publications

(2 citation statements)

References 6 publications

(7 reference statements)

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“…The patient's clinical presentation was also significant for a possible tracheal injury suggested by CT imaging which has a 85% sensitivity of detecting airway lesions [6]. Common findings include pneumomediastinum without pneumothorax and deep cervical air and would have prompted further evaluation with bronchoscopy [6, 7]. However, his brain injury posed an immediate threat to his life and required urgent decompression.…”

Section: Discussionmentioning

confidence: 99%

Perioperative and Intensive Care Management of Pediatric Tracheal Tear

Bhananker

Ramaiah

2014

Case Reports in Medicine

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Management of tracheal tears can prove to be challenging in the perioperative setting. This is a rare condition that can be life threatening. Here, we present a case of seven-year-old boy involved in a high-speed motor vehicle collision. The child sustained multiple injuries including a near fatal head injury, multiple facial fractures, and a tracheal injury associated with pneumomediastinum. Due to the imminent threat of brainstem herniation while being imaged in the CT scanner, the patient underwent an emergent craniotomy to evacuate his evolving intracranial bleed. Imaging prior to the craniectomy suggested a possible tracheal injury, given the extensive pneumomediastinum. However, initial perioperative ventilation was without any difficulty. After stabilization of intracranial pressure (ICP) and hemodynamics, on hospital day 4, the patient returned to the operating room to diagnose and repair his tracheobronchial injury. This is a unique polytrauma case in which a tracheal tear was managed in the midst of other life-threatening injuries.

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Section: Discussionmentioning

confidence: 99%

Perioperative and Intensive Care Management of Pediatric Tracheal Tear

Bhananker

Ramaiah

2014

Case Reports in Medicine

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“…Other more common reasons for persistent pneumothorax and air leak should be ruled out, including blockage or clotting of the thoracostomy tube, necessitating placement of a second tube. 27,28,30,31,33 The diagnosis of tracheobronchial injuries has improved with the use of spiral CT of the chest. Bronchoscopy, however, is still the definitive diagnostic tool ( Figure 3A ).…”

Section: Diagnosis Of Bronchial Injuriesmentioning

confidence: 99%

Management of Blunt Pulmonary Injury

Gallagher

2014

AACN Advanced Critical Care

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Thoracic injuries account for 25% of all civilian deaths. Blunt force injuries are a subset of thoracic injuries and include injuries of the tracheobronchial tree, pleural space, and lung parenchyma. Early identification of these injuries during initial assessment and resuscitation is essential to reduce associated morbidity and mortality rates. Management of airway injuries includes definitive airway control with identification and repair of tracheobronchial injuries. Management of pneumothorax and hemothorax includes pleural space drainage and control of ongoing hemorrhage, along with monitoring for complications such as empyema and chylothorax. Injuries of the lung parenchyma, such as pulmonary contusion, may require support of oxygenation and ventilation through both conventional and nonconventional mechanical ventilation strategies. General strategies to improve pulmonary function and gas exchange include balanced fluid resuscitation to targeted volume-based resuscitation end points, positioning therapy, and pain management.

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