Post traumatic disruption of the trachea: About three adolescents’ cases with literature review

Abstract

Introduction: Tracheal lesions are rare but potentially serious and can cause significant morbidity and mortality. Early diagnosis is essential for optimal management. We report 3 cases of adolescents who were victims of external cervicothoracic trauma. All three patients presented with neck pain, inspiratory dyspnea, and polypnea with subcutaneous cervical emphysema in clinical examination. Nasofibroscopy showed normal appearance and mobility of the vocal cords. Cervical and thoracic CT scan with contrast enhancement was carried out in all our patients that showed tracheal breach in various localizations. The first patient underwent surgical exploration of the penetrating wound in the cervical area. The surgical exploration revealed no damage to the anterior and lateral faces of the trachea. In this case, a sagittal discontinuity on the posterior wall of the trachea was revealed using a rigid bronchoscope. All patients were admitted to the intensive care unit for monitoring and follow-up for 24 to 72 hours and received antibiotics and corticosteroids for 10 days. The patient's symptoms improved throughout the evolution. Conclusion: Early diagnosis is necessary to prevent complications. The gold standard for diagnosis is bronchoscopy. Conservative management is recently considered the best therapeutic choice which also allows the morbidity of surgical treatment to be avoided