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Tracheobronchial injuries in childhood: review of two cases
1Department of Pediatric Surgery, Karl-Franzens-University, Graz, Austria.
Insights
Penetrating tracheobronchial injuries in children are rare but treatable. Prompt diagnosis and nonoperative management are safe and effective, avoiding surgical complications.
Area of Science:
- Pediatric Surgery
- Thoracic Trauma
- Pediatric Airway Management
Background:
- Penetrating injuries to the tracheobronchial tree in pediatric patients are exceptionally uncommon.
- Timely diagnosis is crucial for effective management, with nonoperative approaches often being safe and successful.
- Delayed diagnosis can necessitate surgical intervention, potentially leading to severe complications due to the patient's compromised condition.
Observation:
- Two pediatric cases of penetrating tracheobronchial injury were managed over 12 years.
- Case 1: A 10-year-old boy with an iatrogenic injury.
- Case 2: A 6-year-old boy with a direct injury from an agricultural accident.
Findings:
- Cervical emphysema and bronchoscopy were key diagnostic tools for identifying the tracheobronchial lesions.
- Both pediatric patients were successfully treated conservatively.
- No long-term sequelae were observed in either case following nonoperative management.
Implications:
- This case series supports the safety and efficacy of nonoperative treatment for pediatric penetrating tracheobronchial injuries.
- Highlights the importance of prompt diagnosis in preventing complications associated with delayed surgical intervention.
- Suggests that conservative management should be the primary approach when feasible in pediatric tracheobronchial trauma.
Abstract:
Penetrating injuries of the tracheobronchial tree in children are very rare. With prompt diagnosis nonoperative treatment seems to be appropriate and safe without complications. Delayed diagnosis may result in surgical exploration with severe complications afterwards caused by poor condition at the time of intervention. Two children with penetrating tracheobronchial injuries were referred to our pediatric surgical center in the last 12 years. A 10-year-old boy suffered an iatrogenic penetrating injury of the tracheobronchial tree, and a 6-year-old boy a direct penetrating injury of the distal trachea in an agricultural accident. Cervical emphysema and bronchoscopy identified the lesion in these patients. Both of them could be treated conservatively without any sequelae.