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CASE REPORT
Year : 2019  |  Volume : 21  |  Issue : 1  |  Page : 72-75

Traffic accident like suicide


1 Department of Thoracic Surgery, Nyala Sudan Turkey Training and Research Hospital, Khartoum, Nyala, Sudan
2 Department of Anaesthesia and Reanimation, Nyala Sudan Turkey Training and Research Hospital, Khartoum, Nyala, Sudan
3 Department of Otorhinolaryngology, Nyala Sudan Turkey Training and Research Hospital, Khartoum, Nyala, Sudan

Correspondence Address:
Dr. Huseyin Fatih Sezer
Department of Thoracic Surgery, Nyala Sudan Turkey Training and Research Hospital, Khartoum, Nyala
Sudan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejop.ejop_40_18

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Tracheal injury is a rare pathology, but 30% of all cases can be fatal and 50% of those patients will deteriorate in a couple of hours and may lead to death. The course of treatment must be scheduled by clinical status and severity of pathology; conservative approaches can be followed for minor injuries, but major surgeries must be performed for advanced cases. A 28-year-old male, who suffered from caught with a lasso around the neck in a traffic accident, was brought to our emergency service from a distant medical facility. It has been observed that tracheal integrity was lost, subcutaneous and mediastinal emphysema were evident, and bilateral pneumothorax was significant, especially at right with thorax computed tomography. His clinical condition was bad. Tube thoracostomy placement was successfully achieved from the right side, and neck exploration was performed for tracheostomy in operating theater; a total tracheal rupture was observed between the level of 2 amd 3 cricoid cartilage, and the procedure was terminated after placing a tracheostomy cannula to the distal segment of trachea to wait for considering reconstruction following clinical progression and hemodynamic stabilization of the patient. Following the 7th day after the first operation, the patient was operated. The trachea was repaired by suturing using 3-0 polypropylene sutures. The patient was discharged after 12 h of intensive care and 5 days of follow-up in surgery service. Blunt tracheal injuries may not present any symptoms or signs but may also manifest dramatically. Mortality and morbidity rates may be drastically higher. For this reason, physical examination, radiological findings, and bronchoscopy should be performed early in diagnosis and the most appropriate treatment option that can prevent mortality should be decided quickly.


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