Isolated tracheal rupture: A case report

Tracheobronchial injuries are well-recognized sequelae of massive blunt or penetrating injuries of the neck or chest especially from motor vehicle accidents, and rarely due to simple trauma. Tracheal laceration is more common in adults, since adult’s trachea is relatively more unprotected compared to children. Bronchoscopy is fundamental for diagnosis. CT is useful in visualization the level of rupture. Herein, we report on an instance of a minor cervical trauma leading to isolated posterolateral tracheal wall laceration in a 46-year-old woman. We emphasize the importance of suspected tracheal injury, even with minimal trauma. We also review the literature on posterolateral tracheal wall laceration as an isolated feature after blunt cervical trauma in adults, the mechanism of membranous tracheal rupture, diagnostic features and management options.

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  • Corsten G, Berkowitz RG. Membranous tracheal rupture in children following minor blunt cervical trauma. Ann Otol Rhinol Laryngol 2002;111:197-9.
  • Duval EL, Geraerts SD, Brackel HJ. Management of blunt tracheal trauma in children: a case series and review of the literature. Eur J Pediatr 2007;166:559- 63.
  • Fette A. Trachea rupture lesion in children: the two extremes. Technol Health Care 2008;16:319-29.
  • Cassada DC, Munyikwa MP, Moniz MP, Dieter RA Jr, Schuchmann GF, Enderson BL. Acute injuries of the trachea and major bronchi: importance of early diagnosis. Ann Thorac Surg 2000;69:1563-7.
  • Claes I, Van Schil P, Corthouts B, Jorens PG. Posterior tracheal wall laceration after blunt neck trauma in children: a case report and review of the literature. Resuscitation 2004;63:97-102.
  • Hager J, Gunkel AR, Riccabona U. Isolated longitudinal rupture of the posterior tracheal wall following blunt neck trauma. Eur J Pediatr Surg 1999;9:104-8.
  • Hwang JJ, Kim YJ, Cho HM, Lee TY. Traumatic tracheobronchial injury: delayed diagnosis and treatment outcome. Korean J Thorac Cardiovasc Surg 2013;46:197-201.
  • Kunisch-Hoppe M, Hoppe M, Rauber K, Popella C, Rau WS. Tracheal rupture caused by blunt chest trauma: radiological and clinical features. Eur Radiol 2000;10:480-3.
  • Becmeur F, Donato L, Horta-Geraud P, Fraysse P, Schwaab C, Carrenard C, et al. Rupture of the airways after blunt chest trauma in two children. Eur J Pediatr Surg 2000;10:133-5.
  • Kirkham JR, Blackmore CC. Screening for aortic injury with chest radiography and clinical factors. Emerg Radiol 2007;14:211-7.
  • Moore MA, Wallace EC, Westra SJ. The imaging of paediatric thoracic trauma. Pediatr Radiol 2009;39:485-96.
  • Chen JD, Shanmuganathan K, Mirvis SE, Killeen KL, Dutton RP. Using CT to diagnose tracheal rupture. AJR Am J Roentgenol 2001;176:1273-80.
  • Beiderlinden M, Adamzik M, Peters J. Conservative treatment of tracheal injuries. Anesth Analg 2005;100:210-4.
  • Massard G, Rougé C, Dabbagh A, Kessler R, Hentz JG, Roeslin N, et al. Tracheobronchial lacerations after intubation and tracheostomy. Ann Thorac Surg 1996;61:1483-7.
  • Mussi A, Ambrogi MC, Menconi G, Ribechini A, Angeletti CA. Surgical approaches to membranous tracheal wall lacerations. J Thorac Cardiovasc Surg 2000;120:115-8.