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Case Reports: Rare disease
Conservative approach of a paediatric tracheal rupture
  1. Catarina Marques Duarte1,
  2. Elizabete Vieira2,
  3. Sofia Almeida3 and
  4. Francisco Abecasis4
  1. 1Department of Pediatrics, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal
  2. 2Pediatric Surgery Service, Department of Pediatrics, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Portugal
  3. 3Pediatric Intensive Care Unit; Department of Pediatrics, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal
  4. 4Pediatric Intensive Care Unit; Department of Pediatrics; Lead of Pediatric Interhospital Transport System and Neonatal and Pediatric ECMO Program, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Portugal
  1. Correspondence to Dr Catarina Marques Duarte; catarina.m.duarte{at}gmail.com

Abstract

A girl was brought into the emergency room after a non-penetrating cervical trauma. On physical examination, a rapidly progressing chest subcutaneous emphysema was denoted. The child was immediately intubated and mechanical ventilation was initiated. The CT-scan revealed a rupture to the posterior wall of the trachea and a pneumomediastinum. The child was transferred to the paediatric intensive care unit. A conservative approach was chosen, including tracheal intubation as a bypass through the tracheal injury, sedation to reduce the risk of further tracheal trauma and prophylactic antibiotic therapy. Twelve days after the incident, a bronchoscopy demonstrated the integrity of tracheal mucous and the child was successfully extubated. Three months after hospital discharge she was asymptomatic. In this clinical case, the conservative approach presented a successful outcome, avoiding the risks associated with surgery.

  • Trauma
  • Paediatric intensive care
  • Accidents, injuries

http://dx.doi.org/10.1136/bcr-2022-254494

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    Footnotes

    • Twitter @Catarina Marques Duarte

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: Francisco Abecasis devised the main conceptual ideas. Catarina Marques Duarte wrote the manuscript with support from Sofia Almeida, Elizabete Vieira, Francisco Abecasis. All authors provided critical feedback and helped shape the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.