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Complete Tracheal Transection in a 3-Year-Old After Blunt Neck Trauma: a Case Report
Cameron R Smith1, Gijo Alex1,2, Fernando Zayas-Bazan1,3
1Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA.
Insights
Severe pediatric neck trauma can cause complete tracheal transection. Extracorporeal membrane oxygenation (ECMO) provided vital support for a child with this rare injury, enabling definitive airway management.
Area of Science:
- Trauma Surgery
- Pediatric Critical Care
- Anesthesiology
Background:
- Pediatric laryngotracheal injuries from blunt force trauma are uncommon but serious.
- Severe injuries can cause significant morbidity and mortality.
- Extracorporeal membrane oxygenation (ECMO) is a potential supportive therapy for critical cases.
Observation:
- A 3-year-old girl sustained a complete tracheal transection from blunt neck trauma (all-terrain vehicle accident).
- The injury occurred when her neck impacted a fence.
- The transection was at the C7-T1 vertebral level.
Findings:
- Emergent extracorporeal membrane oxygenation (ECMO) cannulation was initiated for the patient.
- This case highlights the successful use of ECMO in managing severe pediatric tracheal disruption.
- The patient required definitive airway management by a skilled multidisciplinary team.
Implications:
- Prompt recognition and management are crucial for pediatric laryngotracheal trauma.
- ECMO can be a life-saving intervention in severe pediatric tracheal injuries.
- A multidisciplinary approach is essential for optimal outcomes in these complex cases.
Abstract:
Pediatric laryngotracheal injuries from blunt force trauma are rare but can lead to significant morbidity and mortality. In pediatric patients with severe laryngotracheal disruption, extracorporeal membrane oxygenation has been used to improve oxygenation and ventilation until definitive repair can be performed. We describe the case of a 3-year-old girl with blunt neck trauma secondary to an all-terrain vehicle accident in which her neck was clotheslined against a fence, leading to a complete tracheal transection at the C7-T1 level. Emergent extracorporeal membrane oxygenation cannulation was initiated. We discuss the evaluation and management of tracheal injuries and the requisite multidisciplinary team approach. Pediatric patients with laryngotracheal trauma require definitive airway management, which should be performed by skilled personnel.
