[Transsection of the cervical trachea secondary to a closed injury. Apropos of a case]

The successful surgical management of a case of complete blunt traumatic transection of the cervical trachea is reported. The management of this rare pathology is a real challenge for the surgeon with regard to early recognition of the lesion and proper therapeutic strategy. Except in case of respiratory distress and/or major laryngotracheal lesions, where urgent tracheotomy is recommended, diagnostic fiberoptic bronchoscopy should be performed to assess the lesions. Guided intubation can also be contemplated. It seems however more prudent to explore the trachea surgically under mask or IV (Ketalar) anesthesia with maintenance of spontaneous breathing. During this exploration intubation can be guided by the surgeon and general anesthesia be initiated. In cases of complete transection, end-to-end anastomosis using absorbable sutures, avoidance of protective tracheotomy and postoperative low-dose steroids seems to be the treatment of choice to avoid stenotic sequelae. If a postoperative stenosis occurs, it should be treated by laser before contemplating surgical correction.