Gunshot Wound Tracheal Injury and Endotracheal Tube Perforation Into Soft Tissue Pocket With Ventilation Solely...

A patient arrived at the emergency department by ambulance with a gunshot wound to the chest. Concern for tracheal injury was confirmed by imaging, also revealing perforation of the endotracheal tube through the tracheal defect. In the operating room (OR), a fiberoptic bronchoscope was used to visualize the airway, revealing that ventilation was solely occurring through Murphy's eye, which was incidentally lined up with the tracheal defect. A fiberoptic scope was used to reposition the endotracheal tube distal to the injury, securing the airway. This case demonstrates the utility of Murphy's eye and the indispensable role of fiberoptic bronchoscopy in airway navigation.