Abstract
Penetrating tracheobronchial injuries are very rare but life-threatening. The successful diagnosis and treatment of such injuries requires a high-level suspicion of tracheobronchial injury and early, appropriate surgical intervention. In this study, we describe our single surgical experience of such injury. A 76-year-old woman who stabbed her neck while attempting suicide was admitted to our hospital. The primary symptoms of the injury were dyspnea and subcutaneous emphysema. A thoracic tube was inserted into her right thoracic cavity because of right pneumothorax; she was intubated because of airway insufficiency. The patient underwent chest computed tomography, which did not reveal any stabbing-associated vascular or esophageal injury. She underwent otolaryngological surgery under local anesthesia for the cervical tracheal injury. A tracheobronchial injury was detected by bronchoscopic examination during surgery. The patient was referred to us for this injury. After consulting an anesthesiologist, we repaired the damage under spontaneous respiration, using the median full sternotomy approach. Thus, surgical repair was straightforward and did not require ventilation with a tube inserted beyond the injury, PCPS support, or tube insertion through the operative field. The patient was extubated the day after surgery. The postoperative course was excellent. She was discharged 7 days after surgery. It is generally recommended that right posterolateral thoracotomy at the fourth intercostal space be performed using mechanical ventilation with the tube positioned beyond the injury in cases of tracheobronchial injury. We have reported this case on the basis of bibliographical considerations.
