Tracheal injuries not caused by trauma are uncommon, and are usually related to endobronchial procedures, including intubation, and thoracic surgery. The clinical consequences of tracheal injuries can be minimal or life threatening, depending on the extent of injury and time to recognition. Management of nontraumatic tracheal injuries is uncertain, and it ranges from watchful waiting, to endobronchial intervention, to surgical management. A representative case is presented in which a tracheal laceration failed surgical repair, precipitated a pneumothorax, and required endobronchial administration of fibrin glue and 2-octylcyanoacrylate with successful resolution of a tracheopleural fistula. Historically, operative management has been a mainstay of tracheal laceration repair, but recent evidence using endobronchial techniques and cautious monitoring has yielded promising results. Specific approaches to management of tracheal injuries are described, including open surgical technique, bridging with endotracheal tube, endobronchial placement of stents and fibrin glue, and endobronchial surgical repair, as well as potential limitations and complications of these approaches.
Departments of *Medicine
§Medicine—Pulmonary/Critical Care, Santa Barbara Cottage Hospital, Santa Barbara, CA
Present address: Zachary DeBoard, MD, Department of Cardiothoracic Surgery, University of Utah, Salt Lake City, UT.
Disclosure: The authors declare that they have no conflicts of interest.
Address correspondence to: Yuri Matusov, MD, Department of Medicine, Santa Barbara Cottage Hospital, 400 West Pueblo St, Santa Barbara, CA 93103. E-mail: firstname.lastname@example.org.