Abstract

症例は57歳女性．作業中，ゴム紐で前頚部が頭側に絞め上げられ救急搬送された．自覚症状は軽度であったが，直ちに16列Multidetector-row Computed Tomography（MD-CT）を撮影し気管に全周性の断裂と併発する中等度の縦隔気腫を認めたため，緊急手術を施行した．麻酔導入時の気管支鏡検査で咽頭・喉頭部に重度の浮腫と出血を認め，観察中に窒息となったため前頚部皮膚を切開して気管断裂部に挿管して気道を確保した．気管は輪状軟骨と第1気管輪との間で膜様部を7mm残してほぼ完全断裂しており，輪状軟骨は前壁正中で切断されていた．修復は3-0PDSを用いて膜様部の3針を気道内で結紮し，輪状軟骨の前壁頭側は3針甲状軟骨にかけて計14針で非テレスコープ形に結節縫合した．術後は誤嚥や肺炎等の合併症を認めず軽快退院した．

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