Iatrogenic tracheal rupture in a child: case study and review of literature

Area of Science:

• Pediatric Pulmonology
• Thoracic Surgery
• Emergency Medicine

Background:

• Tracheal rupture is an uncommon yet severe injury, particularly in pediatric cases.
• Optimal treatment strategies for pediatric tracheal rupture remain unclear, necessitating case-based evidence.
• Volatile substance abuse, such as butane gas inhalation, can lead to serious medical complications.

Observation:

• A 14-year-old male presented with coma and cardiogenic shock after butane gas inhalation.
• Endotracheal intubation was performed, followed by mechanical ventilation, leading to the development of subcutaneous emphysema and pneumothorax.
• Thoracic computed tomography confirmed tracheal rupture in the absence of vital function deterioration.

Findings:

• The patient's tracheal rupture was successfully managed non-surgically with conservative therapy.
• Recovery was complete, with extubation on day five and discharge on day twelve.
• This case demonstrates the potential efficacy of conservative management in select pediatric tracheal rupture cases.

Implications:

• Conservative management may be a viable option for pediatric tracheal rupture, even after endotracheal intubation.
• Early recognition and multidisciplinary care are crucial for favorable outcomes in pediatric tracheal injuries.
• This case contributes to the limited literature on managing rare pediatric tracheal ruptures, informing future clinical decisions.