Penetrating tracheal injury – A case report

We present an unusual case of penetrating injury trachea. Tracheal injuries are rare and more so when they are sustained on falling down. 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 fall on protruding iron bar from a manhole resulting in a stab wound in neck.

The young male patient presented in the Outpatient Department with an open neck wound, air bubbles were visible. Planned exploration of the wound was done the same day and a puncture wound was seen in cervical trachea. There was no injury to major vessels or nerves, so the wound was debrided and closed in layers and a sternocleidomastoid flap was placed. Patient was shifted to intensive care. Recovery was uneventful. Initial management can be complicated by associated head, neck and thoracic injuries. Orotracheal intubation or tracheostomy through the tracheal wound can be done initially. Trachea can be repaired primarily without any tension on suture line. Mortality rates and the incidence of late complications remain high and have been related to delays in diagnosis and definitive treatment.