Journal of Anaesthesia & Critical Care Case Reports

Vol 9 | Issue 1 | January-April 2023 | Page: 13-15 | Narayanan. K, Geeta Bhandari, Abhishek Madeshia, Shikha Singh

DOI: https://doi.org/10.13107/jaccr.2023.v09i01.213

Author: Narayanan. K [1], Geeta Bhandari [2], Abhishek Madeshia [3], Shikha Singh [4]

[1] Department of Anaesthesiology, E.S.I.C Medical College and Hospital, KK Nagar, Chennai, Tamil Nadu, India.
[2] Department of Anaesthesiology, SSJGIMSR, Almora, Uttarakhand, India.
[3] Department of Anaesthesiology, AIIMS Gorakhpur, Uttar Pradesh, India.
[4] Department of Anaesthesiology, ABVIMS, and Ram Manohar Lohia Hospital, New Delhi, India.

Address of Correspondence
Dr. Sathya Narayanan K
Assistant Professor, Department of Anaesthesiology, E.S.I.C Medical College and Hospital, KK Nagar, Chennai, Tamil Nadu, India.
E-mail: sathyavaan4444@gmail.com

Abstract

A 5-year-old girl presented to the emergency with difficulty breathing and multiple laceration all over the body after dog bite. She presented with unstable vitals and added sounds in chest, an audible inspiratory stridor and visible paradoxical breathing.
Patient was immediately shifted to intensive care unit and Bronchoscopy was performed revealing tracheal tear at 2nd and 3rd rings. CECT Neck and thorax confirmed extensive subcutaneous emphysema. Hypoxemia with uncompensated respiratory acidosis was reported in blood gas analysis. An emergency tracheostomy with size 5.0 mm was done and child was put on mechanical ventilation with appropriate settings.
Suitable antibiotics and intravenous fluid were administered according to her weight along with rabies prophylaxis . After 5 days her chest condition improved and she was successfully weaned off.
Laryngotracheal tear following trauma is uncommon in paediatric population. Chest X-ray will reveal the presence of surgical emphysema and Computed tomography reveals the extent. Hoarseness, strider, dyspnoea are the important symptoms while surgical emphysema is often the only important sign of tracheal laceration.
Keywords: Tracheal, Laceration, Paediatric, Tracheostomy, Bubble CPAP

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