Non-operative management in tracheal injuries: a feasible approach

Abstract

Tracheal injuries secondary to penetrating chest trauma are rare, and the non-operative management of isolated injuries, few successful cases of non-operative management are recorded. A 20-year-old male patient presented after sustaining a penetrating injury to his chest. On clinical evaluation and diagnostic imaging, he had an isolated perforated tracheal injury. Extensive surgical emphysema, bilateral pneumothoraces and a positive finding of tracheal injury on bronchoscopy clinically evidenced it. The patient was managed conservatively in the intensive care unit, endotracheal intubation was placed below the injury and subsequently, associated clinical signs improved; he was extubated and discharged home with no further complications noted. Isolated tracheal injury secondary to trauma is a rare finding. The treatment depends on the size, location and resolution of surgical emphysema and pneumothorax. In the absence of these, surgical management is preferred. Non-operative management for tracheal injuries is favoured in iatrogenic injuries. Isolated tracheal injuries secondary to trauma can be managed non-operatively. With close monitoring in high-care settings and a good understanding of the disease process make successful management of tracheal injuries possible. Conservative management saves both the patient and the health system the burden of undergoing surgical repair.