Isolated Complete Cervical Tracheal Transection in Penetrating Neck Injury: A Unique Case

Abstract

Isolated penetrating neck injuries involving cervical trachea are rare. Cervical tracheal transection is life-threatening and may result in immediate death due to asphyxiation. Early recognition and maintenance of the airway followed by definitive repair are essential for survival. We report a 28-year-old male who presented to the emergency department with a penetrating neck injury. He was dyspneic and cyanosed with neck swelling. Air was gushing from the wound. He was immediately shifted to the operating room. Neck wound exploration revealed complete tracheal transection. The distal trachea was identified and controlled with stay sutures. The endotracheal tube was advanced into the distal trachea through an oral route across the 3 cm gap at the level of the suprasternal notch. Crossfield ventilation was achieved to first repair the posterior layer and then the anterior layer after establishing the airway through the oral cavity. End to end anastomosis was achieved with interrupted 3/0 vicryl. The postoperative course was uneventful and the patient was discharged on the 10th day after bronchoscopy.