Anesthetic Management of Penetrating Tracheal Injury in a 3-Year-Old Child: A Case Report

Penetrating tracheal injuries in children are uncommon and present significant diagnostic and airway challenges. We report the case of a 3-year-old boy who sustained an accidental penetrating neck trauma and was taken up for tracheal repair. Initial radiological evaluation did not reveal any tracheal/bronchial injury, but there was extensive pneumomediastinum. The child exhibited signs of airway compromise along with a deep penetrating injury on the anterior neck, extensive subcutaneous and musculofascial emphysema in the neck and anterior chest wall. Anesthetic management required careful induction, avoiding hemodynamic and airway compromise, smooth and atraumatic intubation, and positive pressure ventilation to localize the rent intraoperatively, via visible bubbling. Pneumothorax, wound infection, and mucus plugging prolonged the postoperative course. This report highlights the role of multidisciplinary coordination, tailored anesthetic strategies, and postoperative care in pediatric airway trauma.