Nontraumatic Tracheal Injuries in Adults: A Case Report and Review of the Literature

Tracheal injuries not caused by trauma are uncommon, and are usually related to endobronchial procedures, including intubation, and thoracic surgery. The clinical consequences of tracheal injuries can be minimal or life threatening, depending on the extent of injury and time to recognition. Management of nontraumatic tracheal injuries is uncertain, and it ranges from watchful waiting, to endobronchial intervention, to surgical management. A representative case is presented in which a tracheal laceration failed surgical repair, precipitated a pneumothorax, and required endobronchial administration of fibrin glue and 2-octylcyanoacrylate with successful resolution of a tracheopleural fistula. Historically, operative management has been a mainstay of tracheal laceration repair, but recent evidence using endobronchial techniques and cautious monitoring has yielded promising results. Specific approaches to management of tracheal injuries are described, including open surgical technique, bridging with endotracheal tube, endobronchial placement of stents and fibrin glue, and endobronchial surgical repair, as well as potential limitations and complications of these approaches.
Source: Clinical Pulmonary Medicine - Category: Respiratory Medicine Tags: Topics in Pulmonary Medicine Source Type: research