A novel method of airway management in a case of penetrating neck injury
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...
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| Published in: | Indian journal of anaesthesia Vol. 60; no. 7; pp. 509 - 511 |
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| Main Authors: | , , |
| Format: | Journal Article |
| Language: | English |
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India
Wolters Kluwer - Medknow Publications
01-07-2016
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| Abstract | 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. Although there was a pleural tear, there were no signs of injury to lung parenchyma. After evaluation, end to end anastomosis of the trachea was planned, for which orotracheal tube was passed with surgical assistance. Patient was shifted to post-operative high dependency unit and was electively ventilated for 7 days and was later successfully extubated under fibre-optic bronchoscope guidance. |
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| AbstractList | 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. Although there was a pleural tear, there were no signs of injury to lung parenchyma. After evaluation, end to end anastomosis of the trachea was planned, for which orotracheal tube was passed with surgical assistance. Patient was shifted to post-operative high dependency unit and was electively ventilated for 7 days and was later successfully extubated under fibre-optic bronchoscope guidance. 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. Although there was a pleural tear, there were no signs of injury to lung parenchyma. After evaluation, end to end anastomosis of the trachea was planned, for which orotracheal tube was passed with surgical assistance. Patient was shifted to post-operative high dependency unit and was electively ventilated for 7 days and was later successfully extubated under fibre-optic bronchoscope guidance. |
| Audience | Academic |
| Author | Maddineni, Sagar Kulkarni, Malavika Prabhu, Manjunath |
| AuthorAffiliation | Department of Anaesthesia, Kasturba Medical College, Manipal University, Manipal, Karnataka, India |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27512169$$D View this record in MEDLINE/PubMed |
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| References | 18955599 - Emerg Med J. 2008 Nov;25(11):711-5 20640146 - Indian J Anaesth. 2009 Jun;53(3):348-51 8943176 - World J Surg. 1997 Jan;21(1):41-7; discussion 47-8 24163462 - Indian J Anaesth. 2013 Jul;57(4):410-2 18545110 - J Trauma. 2008 Jun;64(6):1466-71 22379574 - Korean J Anesthesiol. 2012 Feb;62(2):172-4 11308235 - Can J Surg. 2001 Apr;44(2):122-6 23429024 - BMJ Case Rep. 2013 Feb 20;2013:null Hosalli (key-10.4103/0019-5049.186019-8) 2013 key-10.4103/0019-5049.186019-4 Brywczynski (key-10.4103/0019-5049.186019-1) 2008 Osborn (key-10.4103/0019-5049.186019-2) 2008 Demetriades (key-10.4103/0019-5049.186019-3) 1997 Bhattacharya (key-10.4103/0019-5049.186019-6) 2009 Nason (key-10.4103/0019-5049.186019-7) 2001 Huh (key-10.4103/0019-5049.186019-5) 2012 |
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| Title | A novel method of airway management in a case of penetrating neck injury |
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