Blunt traumatic tracheobronchial injury is rare, but can be potentially life-threatening. It accounts for only 0.5%-2% of all trauma cases. Patients may present with non-specific signs and symptoms, requiring a high index of suspicion with accurate diagnosis and prompt treatment. A 26-year-old female was brought into the emergency department after sustained a blunt trauma to the chest from a high impact motor vehicle accident. She presented with signs of respiratory distress and extensive subcutaneous emphysema from the chest up to the neck. Her airway was secured and chest drain was inserted for right sided pneumothorax. CT of the neck and thorax revealed a collapsed right middle lung lobe with a massive pneumothorax, raising the suspicion of a right middle lobe bronchus injury. Diagnosis was confirmed by bronchoscopy. In view of the difficulty in maintaining her ventilation and persistent pneumothorax with a massive air leak, immediate right thoracotomy via posterolateral approach was performed. The right middle lobar bronchus tear was repaired. There were no intra- or post-operative complications. She made an uneventful recovery. She was asymptomatic at her first month follow-up. A repeated chest X-ray showed expanded lungs. Details of the case including clinical presentation, imaging and management were discussed with an emphasis on the early uses of bronchoscopy in case of suspected blunt traumatic tracheobronchial injury. A review of the current literature of tracheobronchial injury management was presented.
Humans ; Female ; Adult ; Pneumothorax/surgery* ; Bronchi/injuries* ; Wounds, Nonpenetrating/diagnosis* ; Bronchoscopy ; Trachea/injuries*

Injuries caused by free-fall from heights represent a specific form of blunt trauma that can be difficult to interpret, especially when the impact medium is water. On autopsy practice, the immersed bodies with rib fractures and internal organ injuries were often encountered and many studies have reported that impact with the water surface could cause skeletal fracture and visceral organ rupture. The height of the fall and body orientation on impact are the most important factors determining the severity and range of these injuries. In the present case, the victim was a 69-year-old male who weighed 48 kg. Following were the autopsy findings: numerous pin-point epidermal injuries on the body surface (like those due to nibbling by fish), a massive soft tissue hemorrhage in the left upper chest, multiple rib fractures (3rd–7th left ribs), ballooning of the lungs, froth in the trachea and bronchus, pericardial tearing in the right anterolateral side (7-cm long), intra-pericardial hemorrhage, and focal hemorrhage in the adventitia of the intra-pericardial aorta. No sign of an external wound was observed in the left chest area. The cause of death was drowning, and the manner of death was suicide. Unfortunately, the site and height of fall were not investigated.
Adventitia ; Aged ; Aorta ; Autopsy ; Bronchi ; Cause of Death ; Drowning ; Hemorrhage ; Humans ; Lung ; Male ; Rib Fractures ; Rupture ; Suicide ; Tears ; Thorax ; Trachea ; Water ; Wounds and Injuries

OBJECTIVE: To study the radition injury of tracheal mucous membrane tissue after interstitial implanted radioactive 125I in normal rabbit,improve the safety of clinical application. METHOD: Sixty New Zealand rabbits, weighing 2.15-2.30 kg, were randomly divided into 1 w, 1 m, 2 m, 4 m and the control group, the control group was further divided into four subgroups. The 0.8mCi 125I seeds were implanted into the tissue by the first tracheal ring in the treatment groups and nonradioactive seeds were implanted in the control group. Taking the tracheal mucous membrane tissue for pathological examination by HE staining to observe the mucosal injury and VEGF, Pan-Cadherin immunohistochemical staining to observe the expression in differernt time. RESULT: Immunohistochemical staining: VEGF and Pan-Cadherin have statistically significant differences in the expression on different time, the expression is dynamic. CONCLUSION The expression of VEGF and Pan-Cadherin reflect the radioactive 125I seed has little influence on normal trachea tissue and the damage can be repaired by the regeneration of the basal cell.
Animals ; Brachytherapy ; adverse effects ; Iodine Radioisotopes ; adverse effects ; Rabbits ; Radiation Injuries ; pathology ; Trachea ; pathology ; radiation effects

Patients with severe neurological deficit, such as hypoxic ischemic injury, cerebral infarction, and traumatic brain injury, often show comatose mental status and require maintenance of long-term tracheostomy for pulmonary toileting. However, several complications, which are mostly related to the cannula, invariably occur. Permanent tracheostoma is a short, skin-lined, noncollapsing, self-sustaining opening by suturing the denuded skin lining to the margin of the tracheal stoma. This tube-free method is a useful alternative to make long-term airway without tube-related complications in chronic diseases, such as obstructive sleep apnea, and laryngeal cancer, however, it has not yet been reported in chronic brain injured patients. This case report illustrates 3 cases of vegetative patients in our rehabilitation clinic who underwent successful procedure of permanent tracheostoma. Permanent tracheostoma has some benefits associated with the free of tube-related complications, and can be considered as a useful alternative way for chronic brain injured patients with long-term tracheostomy.
Brain Injuries/complications/*rehabilitation ; Humans ; Male ; Middle Aged ; Trachea/*surgery ; Tracheostomy/*methods ; Treatment Outcome

Analysis and summarize the causes and principles of the cases of tracheal tube rupture. Report one case of adult tracheal tube rupture. Review the past literature content and combine with our experience. Comprehend the clinical manifestations and treatment of tracheal tube rupture is very important for prevention.
Adult ; Humans ; Intubation, Intratracheal ; Rupture ; etiology ; prevention & control ; Trachea ; injuries

OBJECTIVETo observe the short term effect of argon plasma coagulation (APC) combined with cryotherapy via bronchoscopy for treatment of severe post-intubation tracheal stenosis in a child.

METHODA 3-year old boy was admitted for cephalothorax abdominal compound trauma and dyspnea, who had severe post-incubation tracheal stenosis. The agreement about the operation risk was signed by the parents. Endotracheal APC procedure was performed with a bronchoscope under general anesthesia. The APC probe was put into the working channel of the bronchoscope. The stenotic lesion was endoscopically visualized and then coagulated by argon plasma. Such coagulation was carried out several times at the stenotic site until it gradually became dilated. The devitalized tissue was mechanically removed with grasping forceps. Thereafter, bronchoscopic cryosurgery was repeatedly performed at the stenotic site. Clinical symptoms, signs and bronchoscopic manifestations were observed right after operation, after 1 day, 10 days, 1 month and 6 months separately.

RESULTTracheal tissue hyperplasia and cyanosis disappeared, laryngeal stridor and dyspnea improved obviously right after the operation. General condition of the patient was well, there was no laryngeal stridor and dyspnea 10 days after operation. The mucosa of the surgical site was smooth and no tracheostenosis was seen under bronchoscope at 1 month and 6 months after the operation.

CONCLUSIONArgon plasma coagulation combined with cryotherapy via bronchoscope is an effective method to treat tracheal stenosis of children, which needs further exploration for the application.

Argon Plasma Coagulation ; methods ; Bronchoscopy ; Child, Preschool ; Cryotherapy ; Humans ; Intubation, Intratracheal ; adverse effects ; Laryngeal Diseases ; etiology ; surgery ; Male ; Trachea ; surgery ; Tracheal Stenosis ; etiology ; surgery ; Treatment Outcome ; Wounds and Injuries ; surgery

Aged ; Female ; Humans ; Iatrogenic Disease ; Lacerations ; etiology ; Pneumoperitoneum ; etiology ; therapy ; Trachea ; injuries ; Tracheostomy ; adverse effects ; instrumentation ; Treatment Outcome

OBJECTIVETracheobronchial injuries are defined as injuries involving the trachea and/or bronchi from the level of the cricoid cartilage extending up to the division of the bronchi. We present a case series with most of the tracheobronchial injuries found to be sustained after penetrating trauma.

METHODSA retrospective review was performed at the Aga Khan University, Karachi, Pakistan. From January 2004 to December 2009, 168 patients with thoracic trauma were treated, of whom 15 were recognized to have major tracheobronchial and pulmonary injuries.

RESULTSThe average age was 31 years with most of the patients being male (14:1). Among them,11 patients had penetrating trauma as the main cause of injury, 3 patients had blunt trauma from road traffic accidents, only 1 patient had combined trauma (blunt and penetrating trauma). Eight patients were diagnosed based on radiological findings. All the patients were treated surgically. Lobectomy was the most common intervention performed in 7 patients. The mortality rate was 7% (1 patient). Most patients survived with no sequelae (10 patients) while 5 survived with disability. We found that penetrating trauma was the leading cause of injury in our series. The severity of injury depends upon the weapon causing the trauma. Patients in our series had multiple injuries and required surgical management.

CONCLUSIONSTracheobronchial injuries are rare but potentially life threatening. They require quick diagnosis and management. Diagnosis tends to be difficult since there are no specialised diagnostic modalities available at present.

Adult ; Bronchi ; injuries ; Developing Countries ; Female ; Humans ; Male ; Retrospective Studies ; Trachea ; injuries

Powered by compressed air, a nail gun is an essential alternative tool to a hammer on any construction site. This useful machine launches nails at high speed, automatically embedding them in a piece of wood in only a fraction of a second. In spite of its convenience, life-threatening and fatal nail gun injuries can occur when a nail gun is misused, such as in a suicide attempt, or when the operator has insufficient training because combustion nail guns are capable of firing projectiles at velocities higher than 150 m per second. Although injuries by nail guns are rarely reported, there have been reports of nail gun injuries to the head and the trachea in Korea. In the emergency room, the authors experienced a patient injured by an accidental shooting of a nail gun while working in construction. In that accident, a nail penetrated the patient's cervical vertebra through the left cheek. This report is aimed at studying medical treatment for patients with penetrating injuries caused by nail guns.
Cheek ; Compressed Air ; Emergencies ; Firearms ; Fires ; Head ; Humans ; Korea ; Nails ; Neck ; Neck Injuries ; Spine ; Suicide ; Trachea ; Wood

Adult ; Humans ; Male ; Neck Injuries ; complications ; Pharynx ; injuries ; Trachea ; injuries