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An unusual case of penetrating tracheal ("Cut throat") injury due to chain snatching: The ideal airway management

Author(s): Venkatachalam Sengoda | Palaniswamy Selvaraj D | Rangarajan Muthukumaran | Mani Kumarasami | Palanivelu Chinnusamy

Journal: Indian Journal of Critical Care Medicine
ISSN 0972-5229

Volume: 11;
Issue: 3;
Start page: 151;
Date: 2007;
Original page

Keywords: Penetrating tracheal injury | orotracheal intubation | tracheostomy

Background: Traumatic airway injuries are fortunately rare. Though injuries can be obvious and initial management straightforward, the diagnosis can be difficult. We present a case of penetrating cervical tracheal injury due to ′chain snatching′ in a young female. Case Report: The young female patient presented in the Emergency Department with a bleeding neck wound. Orotracheal intubation was done after resuscitation, revealing a transected trachea. There was no injury to major vessels or nerves, so the wound was debrided and closed in layers and a tracheostomy tube was placed through the transected trachea. Postoperatively, the patient was ventilated for 72h, after which she completely recovered. Discussion: Initial management can be complicated by associated head, neck and thoracic injuries. Orotracheal intubation or tracheostomy through the tracheal wound is the ideal way to manage these cases. Surgical repair of the trachea is not always necessary. Mortality rates and the incidence of late complications remain high and have been related to delays in diagnosis and definitive treatment.

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