Tracheal Laceration Due to Dog Bite in a Five Year Old Girl: The Chronicles of a Complex Case Managed Successfully
Vol 9 | Issue 1 | January-April 2023 | Page: 13-15 | Narayanan. K, Geeta Bhandari, Abhishek Madeshia, Shikha Singh
Author: Narayanan. K , Geeta Bhandari , Abhishek Madeshia , Shikha Singh 
 Department of Anaesthesiology, E.S.I.C Medical College and Hospital, KK Nagar, Chennai, Tamil Nadu, India.
 Department of Anaesthesiology, SSJGIMSR, Almora, Uttarakhand, India.
 Department of Anaesthesiology, AIIMS Gorakhpur, Uttar Pradesh, India.
 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.
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
1. Marathe US, Tran LP. Pediatric neck trauma causing massive subcutaneous emphysema. Journal of Trauma and Acute Care Surgery. 2006 Aug 1;61(2):440-3.
2. Shine NP, Sader C, Coates H. Cervicofacial emphysema and pneumomediastinum following pediatric adenotonsillectomy: a rare complication. International journal of pediatric otorhinolaryngology. 2005 Nov 1;69(11):1579-82.
3. Alao T, Waseem M. Neck Trauma. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470422
4. Duval EL, Geraerts SD, Brackel HJ. Management of blunt tracheal trauma in children: a case series and review of the literature. European journal of pediatrics. 2007 Jun;166(6):559-63.
5. Fette A. Trachea rupture lesion in children: the two extremes. Technology and Health Care. 2008 Jan 1;16(5):319-29.
6. Claes I, Van Schil P, Corthouts B, Jorens PG. Posterior tracheal wall laceration after blunt neck trauma in children: a case report and review of the literature. Resuscitation. 2004 Oct 1;63(1):97-102.
7. Gupta S, Donn SM. Continuous positive airway pressure: to bubble or not to bubble?. Clinics in perinatology. 2016 Dec 1;43(4):647-59.
8. Moore MA, Wallace EC, Westra SJ. The imaging of paediatric thoracic trauma. Pediatric radiology. 2009 May;39(5):485-96.
9. Sogut O, Cevik M, Boleken ME, Kaya H, Dokuzoglu MA. Pneumomediastinum and subcutaneous emphysema due to blunt neck injury: a case report and review of the literature. JPMA-Journal of the Pakistan Medical Association. 2011 Jul 1;61(7):702.
10. Andani NM, Savitri PD. Persistent secondary spontaneous pneumothorax as a complication of tuberculosis infection: a case report. Intisari Sains Medis. 2022 Feb 28;13(1):131-5.
11. Garcia VF. Animal bites and Pasturella infections. Pediatrics in review. 1997 Apr 1;18(4):127-30.
12. Morgan M, Palmer J. Dog bites. Bmj. 2007 Feb 22;334(7590):413-7.
|How to Cite this Article:Narayanan K, Bhandari G, Madeshia A, Singh S | Tracheal Laceration Due to Dog Bite in a Five Year Old Girl: The Chronicles of a Complex Case Managed Successfully | January- April 2023; 9(1): 13-15 | https://doi.org/10.13107/jaccr.2023.v09i01.213|
Tags: Bubble CPAP, Laceration, Paediatric, Tracheal, tracheostomy