Management of life-threatening tracheal emergencies

Abstract

OBJECTIVE: Tracheal pathologies are life-threatening in all age groups and may result in death if urgent action isn’t taken. The aim of this study was to present cases of rare and life-threatening tracheal pathologies and discuss the management of these in the light of literature.

METHODS: A retrospective analysis was made of 8 patients who underwent surgery for emergency tracheal pathologies in our clinics between 2013 and November 2018. The patients were evaluated in terms of age, gender, etiology, symptoms, location of pathology, surgical approach, treatment technique, and length of hospital stay.

RESULTS: Of the 8 cases with tracheal pathology, 4(50%) had tracheal rupture, 3(37.5%) had tracheal stenosis due to prolonged post-intubation, and one (12.5%) had a tracheal tumor. The cases with tracheal rupture comprised 2 females and 2 males with a mean age of 28.5 years (range, 16-48 years). The cases with tracheal stenosis were 2 females and 1 male with a mean age of 29.3 years (range, 25-36 years). The patient with a tracheal tumor was 34 years old and had been diagnosed late. Preoperative mortality as a result of hypoxia was seen in one case with carina rupture. No postoperative morbidity or mortality were observed in all 7(87.5%) cases who underwent surgery.

CONCLUSION: Early diagnosis, treatment, determination of the location and form of the pathology is very important in tracheal pathologies. In surgical treatment, wide resection should be avoided as much as possible, and the surgical approach should be determined according to the shape of the pathology, wiht end-to-end anastomosis and/or primary repair applied when possible.