MANAGEMENT OF THE BLUNT PEDIATRIC CERVICAL TRAUMA – CHALLENGE FOR THE TRAUMA SURGEON AND THE OPTIONS OF SOLVING THEIR EMERGENCY CONDITIONS (A CASE REPORT)

Novosti Khirurgii. 2014 Jul-Aug; Vol 22 (4): 488-491

Novosti Khirurgii. Vol 22 (4): 488-491

Introduction Tracheal injuries are uncommon but potentially fatal, while the incidence of tracheobronchial injury is reported to involve in 4% of all cases of thoracic trauma [1]. Postoperative mortality rate is reported to be up to 59% of cases after tracheobronchial rupture in motor vehicle accidents (MVA), but these patients often have associated with multi-organ trauma [2, 3]. Despite on the rarity, tracheobronchial damages can always be found behind closed chest trauma and can sometimes be detected with a high degree of suspicion. Its treatment should start early, solve airway and respiratory problems and avoid mediastinitis using antibiotic cover [4]. Blunt cervical trauma is not commonly a single organ trauma, and it is generally associated with other injuries to associated surrounding anatomical structures such as bone, muscle or neurovascular bundle, due to the mechanism of injury, force and angle, as well as the status of tissues (age of the patient). Tracheal injury can be found associated to closed blunt thoracic trauma, and can be present as damage to the tracheobronchial tree damages above and below the carina. Such injuries are a challenge in diagnostics and treatment to emergency physician, trauma surgeon or anesthetists. In this article we present one of the rare cases with blunt damage to the pediatric trachea, and describe treatment strategies in the management of blunt injuries of the cervical trachea at its level. We are convinced that this demonstration is as rare as it is interesting to the interested reader and will serve to deal with this type of trauma, and highlight the potential problems it carries with its´ diagnosis.
July 2014
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