Traffic accident like suicide

Abstract

Tracheal injury is a rare pathology, but 30% of all cases can be fatal and 50% of those patients willdeteriorate in a couple of hours and may lead to death. The course of treatment must be scheduled byclinical status and severity of pathology; conservative approaches can be followed for minor injuries,but major surgeries must be performed for advanced cases. A 28‑year‑old male, who suffered fromcaught with a lasso around the neck in a traffic accident, was brought to our emergency servicefrom a distant medical facility. It has been observed that tracheal integrity was lost, subcutaneousand mediastinal emphysema were evident, and bilateral pneumothorax was significant, especiallyat right with thorax computed tomography. His clinical condition was bad. Tube thoracostomyplacement was successfully achieved from the right side, and neck exploration was performed fortracheostomy in operating theater; a total tracheal rupture was observed between the level of 2 amd3 cricoid cartilage, and the procedure was terminated after placing a tracheostomy cannula to thedistal segment of trachea to wait for considering reconstruction following clinical progression andhemodynamic stabilization of the patient. Following the 7th day after the first operation, the patientwas operated. The trachea was repaired by suturing using 3‑0 polypropylene sutures. The patientwas discharged after 12 h of intensive care and 5 days of follow‑up in surgery service. Blunt trachealinjuries may not present any symptoms or signs but may also manifest dramatically. Mortality andmorbidity rates may be drastically higher. For this reason, physical examination, radiological findings,and bronchoscopy should be performed early in diagnosis and the most appropriate treatment optionthat can prevent mortality should be decided quickly.