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Tracheal tear

Benjamin Nicholson, Harinder Dhindsa, Louis Seay
BACKGROUND: Blunt injuries to the cervical trachea remain rare but present unique and challenging clinical scenarios for prehospital providers. These injuries depend on prehospital providers either definitively securing the injured airway or bridging the patient to a treatment facility that can mobilize the necessary resources. CASE SUMMARY: The case presented here involves a clothesline injury to a pediatric patient that resulted in complete tracheal transection and partial esophageal transection...
October 4, 2016: Prehospital Emergency Care
Ehab Hussein, Vikas Pathak, Ray Wesley Shepherd, Samira Shojaee
Iatrogenic tracheal laceration is a known complication of emergent endotracheal intubation. Patients with tracheal laceration present a therapeutic challenge. There is no established standard treatment approach in this patient population. Interventions reported include conservative management, stent placement, or surgery. We present our experience of tracheal tears in patients with respiratory failure successfully managed with polyurethane-covered nitinol stent, including three cases of post-intubation and one case of post-surgical tracheostomy tracheal injury...
September 3, 2016: Journal of Trauma and Acute Care Surgery
Chang Jiang Li, Lei Cheng, Haitao Wu, Lei Tao, Liang Zhou
Ideal speech restoration remains a difficult challenge for patients undergoing laryngectomy so far. Our aim was to explore the feasibility of neoglottic reconstruction with sternohyoid muscles on upper-tracheal orifice after total laryngectomy which can obtain relatively ideal voice rehabilitation. Fifteen male patients are laryngectomized, of whom eight with standard total laryngectomy and seven underwent nonstandard total laryngectomy with epiglottis conserved. After laryngectomy, the upper margin of the anterior hypopharyngeal mucosa (postcricoid mucosa) was stitched to the posterior margin of upper-tracheal orifice and a triangle-shaped neoglottis on upper-tracheal orifice was reconstructed using bilateral sternohyoid muscles near the hyoid bone which were sutured to the posterior wall and bilateral of upper-tracheal orifice...
August 24, 2016: European Archives of Oto-rhino-laryngology
Tomasz Gil, Janusz Warmus, Janusz Włodarczyk, Zbigniew Grochowski, Krzysztof Bederski, Piotr Kocoń, Piotr Talar, Jarosław Kużdżał
INTRODUCTION: Iatrogenic tracheobronchial injuries are rare. AIM: To analyse the mechanism of injury, symptoms and treatment of these patients. MATERIAL AND METHODS: Retrospective analysis of hospital records of all patients treated for main airway injuries between 1990 and 2012 was performed. RESULTS: There were 24 patients, including 21 women and 3 men. Mean time between injury and initiation of treatment was 12 hours (range: 2-48)...
June 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Malavika Kulkarni, Manjunath Prabhu, Sagar Maddineni
Direct injury to airway is a rare event and also a challenge to anaesthesiologist and surgeon. We present a case report of open tracheal injury with right pneumothorax in a young male following assault with a sharp weapon. In spite of a chest tube in situ, the patient came with collapse of one lung and tachypnoea which required surgical exploration. Lower airway was evaluated by fibre-optic bronchoscopy through the open tracheal wound while he was awake and tracheal tube was passed over the bronchoscope. There was no vascular or oesophageal injury detected...
July 2016: Indian Journal of Anaesthesia
Yoshihisa Morimoto, Takaki Sugimoto, Fumiya Haba, Hideki Sakahira
INTRODUCTION: There are many publications reporting the use of TachoSil sheets for sutureless repair. Trauma doctors have recently reported that chitosan-based sheets can efficiently achieve hemostasis for active bleeding. PRESENTATION OF CASE: An 85-year-old man was diagnosed with left ventricle free wall rupture that caused cardiac tamponade and cardiogenic shock. Extracorporeal membrane oxygenator (ECMO) was started immediately and surgical repair was planned...
2016: International Journal of Surgery Case Reports
Benjamin E Lee, Robert J Korst
We report the case of a 63-year-old woman who required emergent intubation after a choking episode at home. It resulted in a 5-cm tear in the membranous trachea. She was treated by placement of a temporary tracheal stent, which was successfully removed 3 months later.
July 2016: Annals of Thoracic Surgery
Mineto Kamata, Mumin Hakim, Joseph D Tobias
BACKGROUND: In recent years, there has been a shift in airway management with the use of cuffed endotracheal tubes (ETT) in pediatric patients. While the use of a syringe to deflate the cuff is generally recommended, anecdotal observations suggest that some healthcare practitioners tear off the pilot balloon from ETT to deflate the cuff. This study was conducted to estimate the residual volume in the cuff when the pilot balloon is torn off for deflation. METHOD: The in vitro study was conducted in three phases...
July 2016: International Journal of Pediatric Otorhinolaryngology
Khaldoun ElAbed, Ahmad Shawky, Mo Barakat, Donald Ainscow
STUDY DESIGN: Retrospective case cohort study done between 2002 and 2012. PURPOSE: To assess the mid-term clinical and radiological outcomes of 1-level and 2-level anterior cervical discectomy and fusion (ACDF) with stand-alone trabecular metal cages. OVERVIEW OF LITERATURE: ACDF is the gold standard surgical treatment for cervical degenerative disease. The usual surgical practice is to use an anteriorly placed fusion plate with or without interdiscal cages...
April 2016: Asian Spine Journal
Seyed Ziaeddin Rasihashemi, Nassir Rostambeigi, Seyed Reza Saghebi, Faeze Daghigh, Ali Ramouz
Various surgical approaches may be employed for esophageal resection. Major airway injuries due to transhiatal esophagectomy include vertical tears in the membranous trachea. Tracheal injury is an uncommon but potentially fatal complication. This article describes the technique to repair the posterior membranous tracheal tear, extended just over the carina through a transcervical-transsternal approach, thereby avoiding a second thoracotomy. Six patients with posterior membranous tracheal injury underwent this procedure...
February 24, 2016: Asian Journal of Surgery
L Q Wang, J Zhang, J Wang, Y H Pei, Y L Wang, X J Qiu, T Wang, M Xu, C Y Zhang
OBJECTIVE: To explore the techniques and related complication management of airway metal stents removal with rigid bronchoscope under general anesthesia. METHODS: We reviewed 20 patients who had received rigid bronchoscopic stents removal under general anesthesia from Jan. 2008 to Jan. 2015. The clinical data were analyzed retrospectively. The indications for stents removal and potential difficulties encountered, the relationship between techniques and related complications of stents removal were discussed and analyzed, and our experiences were summarized...
February 2016: Chinese Journal of Tuberculosis and Respiratory Diseases
Mian Wang, Guangqi Chang, Henghui Yin, Chen Yao, Jinsong Wang, Shenming Wang
OBJECTIVE: To summarize the experience of endovascular repairing aortic arch disease hybrid with supra-arch debranching procedures. METHODS: It was a retrospective study. From January 2002 to December 2014, 42 high risk patients with aortic arch disease were treated by supra-arch debranching hybrid with subsequent endovascular repair in the First Affiliated Hospital of Sun Yat-sen University. There were 39 male and 3 female patients with a mean age of (53±13) years (ranging from 34 to 80 years)...
November 1, 2015: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
W King, J Teare, T Vandrevala, S Cartwright, K B Mohammed, B Patel
A can't intubate, can't ventilate scenario can result in morbidity and death. Although a rare occurrence (1:50 000 general anaesthetics), it is crucial that anaesthetists maintain the skills necessary to perform cricothyroidotomy, and are well-equipped with appropriate tools. We undertook a bench study comparing a new device, Surgicric(®) , with two established techniques; the Melker Emergency Cricothyroidotomy, and a surgical technique. Twenty-five anaesthetists performed simulated emergency cricothyroidotomy on a porcine model, with the primary outcome measure being insertion time...
February 2016: Anaesthesia
Matthew A Warner, Jonathan F Fox
Tracheal wall disruption is a rare complication of endotracheal intubation, typically occurring in the posterior (membranous) trachea lacking cartilaginous support. We present the case of a 68-year-old man who developed an anterior tracheal tear after routine endotracheal intubation, most likely occurring secondary to protrusion of a factory-preloaded stylet beyond the distal orifice of the endotracheal tube. Tracheal disruption should be considered in any patient with subcutaneous emphysema and respiratory distress after tracheal extubation and confirmed with bronchoscopy...
February 15, 2016: A & A Case Reports
Mohammed M Al-Balawi, Khalid Al-Mobaireek, Wadha Alotaibi, Abdullah Al-Shamrani, Khalid S Ahmad, Suhail Al-Saleh
INTRODUCTION: Air leak is a well-recognized complication of advanced cystic fibrosis in older children and adults but is extremely rare in infants. To the best of our knowledge, this is the youngest reported pediatric case of an air leak from a major airway. CASE PRESENTATION: A 4-month-old Yamani baby girl with a family history of cystic fibrosis initially presented with a history of a persistent paroxysmal cough for 3 weeks and vomiting for 1 week. Laboratory evaluation indicated pseudo-Bartter's syndrome...
2015: Journal of Medical Case Reports
Frederik W van Ginkel, Justin Padgett, Gisela Martinez-Romero, Matthew S Miller, Kellye S Joiner, Stephen L Gulley
Infectious bronchitis virus (IBV) is an endemic disease of chickens and a major contributor to economic losses for the poultry industry despite vaccination. Recent observations indicated that chicks may have an immature immune system immediately after hatching when vaccinated for IBV. Therefore we hypothesized that early IBV vaccination will generate an immature, poorly protective IBV-specific immune response contributing to immune escape and persistence of IBV. To test this hypothesis the IBV-specific immune response and immune protection were measured in chicks vaccinated at different ages...
May 28, 2015: Vaccine
Henri de Lesquen, Jean-Philippe Avaro, Lucile Gust, Robert Michael Ford, Fabien Beranger, Claudia Natale, Pierre-Mathieu Bonnet, Xavier-Benoît D'Journo
This review aims to answer the most common questions in routine surgical practice during the first 48 h of blunt chest trauma (BCT) management. Two authors identified relevant manuscripts published since January 1994 to January 2014. Using preferred reporting items for systematic reviews and meta-analyses statement, they focused on the surgical management of BCT, excluded both child and vascular injuries and selected 80 studies. Tension pneumothorax should be promptly diagnosed and treated by needle decompression closely followed with chest tube insertion (Grade D)...
March 2015: Interactive Cardiovascular and Thoracic Surgery
Attila Ovári, Tino Just, Steffen Dommerich, Volker Hingst, Arne Böttcher, Tobias Schuldt, Ellen Guder, Thomas Mencke, Hans-Wilhelm Pau
Iatrogenic tracheal rupture is a rare complication after intubation. We present three patients with tracheal tears. In all of these patients, a common finding was a lesion of the posterior tracheal wall with postoperative subcutaneous and emphysema as the first clinical sign of the rupture. Diagnosis and follow-up were based on clinical and endoscopic findings and chest computed tomography (CT) scans. In our cases with progressive subcutaneous and mediastinal emphysema or dyspnea, we performed a tracheotomy and bypassed the lesion with a tracheostomy tube to avoid an increase in air leakage into the mediastinum...
June 2014: Journal of Thoracic Disease
S Sanna, M Monteverde, M Taurchini, M Mengozzi, G Genestreti, W Grossi, D Argnani, D Bettini, D Dell'Amore
INTRODUCTION: We report the case of a patient who presented with subcutaneous emphysema, dyspnea and cough 7 days after total thyroidectomy for cancer. In addition we review the Literature and discuss the therapeutic challenges as well as management options. CASE REPORT: A 17-year old female patient underwent a total thyroidectomy with right cervical lymph adenectomy for papillar cancer. Lung metastases are present. On postoperative day 7 she presented with face and neck swelling due to subcutaneous emphysema, dyspnea and persistent cough...
March 2014: Il Giornale di Chirurgia
Sanjay M Bhananker, Ramesh Ramaiah
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...
2014: Case Reports in Medicine
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