Nontraumatic Tracheal Injuries in Adults: A Case Report and Review of the Literature. Issue 1 (January 2018)

• Record Type: Journal Article
• Authors: Matusov, Yuri; DeBoard, Zachary; West, Phillip N.; Sager, Jeffrey S.
• Is Part Of: Clinical pulmonary medicine. Volume 25:Issue 1(2018)
• Publication Date: 2018-01
• Subjects: interventional pulmonology -- endobronchial therapy -- tracheal injury -- thoracic surgery; Lungs -- Diseases -- Periodicals; 616.24005
• DOI: 10.1097/CPM.0000000000000240
• Languages: English
• ISSNs: 1068-0640

Abstract

Abstract : Tracheal injuries not caused by trauma are uncommon, and are usually related to endobronchial procedures, including intubation, and thoracic surgery. The clinical consequences of tracheal injuries can be minimal or life threatening, depending on the extent of injury and time to recognition. Management of nontraumatic tracheal injuries is uncertain, and it ranges from watchful waiting, to endobronchial intervention, to surgical management. A representative case is presented in which a tracheal laceration failed surgical repair, precipitated a pneumothorax, and required endobronchial administration of fibrin glue and 2-octylcyanoacrylate with successful resolution of a tracheopleural fistula. Historically, operative management has been a mainstay of tracheal laceration repair, but recent evidence using endobronchial techniques and cautious monitoring has yielded promising results. Specific approaches to management of tracheal injuries are described, including open surgical technique, bridging with endotracheal tube, endobronchial placement of stents and fibrin glue, and endobronchial surgical repair, as well as potential limitations and complications of these approaches.