Blunt tracheal transection repair requiring open abdominal management

A 19-year-old man sustained multiple injuries during a motorcycle accident. A computed tomographic scan revealed that the trachea was completely transected, and the endotracheal tube did not reach the distal stump. Extracorporeal membrane oxygenation was used to maintain oxygenation and avoid mediastinal emphysema. Tracheal anastomosis through a right thoracotomy was planned initially, but prior to the operation, extracorporeal membrane oxygenation flow and respiratory condition deteriorated, with evidence of oxygen desaturation. An abdominal compartment syndrome was diagnosed, and open abdominal management was performed. Therefore, the patient had to undergo tracheal anastomosis through a median sternotomy in the supine position. The laparotomy was closed, and the patient was discharged without respiratory complications.