A Case of Tracheal Injury After Machinary Injury of the Neck.

A Case of Tracheal Injury After MACHINARY INJURY   OF THE NECK.

ABSTRACT:
Tracheal injuries are a rare, but serious, complicationafter neck trauma . Tracheal rupture is a rare, potentially life-threatening lesion that can be spontaneous in a minority of cases or,in the majority of cases, iatrogenic or traumatic. We present
a case of traumatic tracheal rupture managed bysurgical repair . We will discuss the diagnosis, treatment and evolution of this
rare life-threatening lesion.

Case report:
15yr old female normotensive ,nondiabetic ,euthyroid presented with machinery injury neck,( band-saw belt injury) on 15-06-2011 patient was brought to SKIMS medical collage(not a teritary care center) were the patient was resuscitated and examined .on examination patient had lacerated wound over anterior aspect of neck patient was bleeding from wound and visible air bubbls   were noticed .imprint of band-saw belt over posterior aspect of neck were seen. Patient had respiratory distress. Patient was taken to emergency operation theater were tracheostomy   was done. Operative findings were copmlete circumfertional cricotracheal separation no pharyngeal injury no laryngeal injury.in view of complete disruption of trache patient was reffered to teriatry care center.on arrival in emergency patient was concious oriented with time place and person, hemodynamically stable breathing comfortable with oxygen saturation of 90%.tracheostomy was in situ.CECT neck and chest was done which was showing large tracheal dehiscence (subcricoid)with pneumomediastinum and neck emphysema with RT. sided blood pnumonitis   it was decided to shifte the patient to emergency operation theater   and patient was intubated with 7.0 size endotracheal tube neck wound was explored the intraoperative findings were complete disruption of trachea at the leval of cricothyroid membrene, vocal cords visible in the lumen of proximal disrupted end,tracheostomy tube were placed in distal disrupted end oesophagus...