Rupture of the thoracic trachea following blunt trauma: Diagnosis by CAT scan

A case of isolated rupture of the thoracic trachea due to blunt trauma in a 4-year-old child is presented. The rarity of this injury and its initial presentation as massive subcutaneous emphysema and bilateral pneumothoraces warrant its description. This child was diagnosed as having a tracheal injury by computed tomography scan. The diagnosis was confirmed at bronchoscopy and was successfully treated by thoracotomy and primary closure of a 3-cm rent in the membranous portion of the trachea. There was difficulty with intraoperative ventilation due to the large air leak through the tracheal tear. This was controlled by intermittent tamponade of the defect with sequential closure. Postoperatively, the child did well and was discharged on the sixth postoperative day. Rigid bronchoscopy done 2 months later showed no abnormality. This case demonstrates that computed tomography is helpful in the diagnosis of tracheal injuries. The treatment may require early operative intervention and closure of the defect.