Anesthetic management of a patient with closed tracheal transection.

Abstract

Closed tracheal injury is a rare clinical emergency that is prone to misdiagnosis and missed diagnosis. Improper management can be life-threatening. This report describes the anesthetic management of a patient with closed tracheal transection undergoing airway reconstruction surgery. The patient, a 33-year-old male, presented with head and neck pain and dyspnea 4 hours after a car accident. CT with 3-dimensional airway reconstruction revealed upper tracheal transection. Emergency cervical exploration and end-to-end tracheal anastomosis were performed under general anesthesia. The anesthetic approach included preserving spontaneous respiration with mild sedation and analgesia, followed by fiberoptic bronchoscope-guided nasal tracheal intubation after confirming the transection site. The airway was successfully reconstructed in cooperation with the surgical team. The patient recovered well postoperatively and was discharged without complications. One-year follow-up showed no adverse outcomes. For patients with closed tracheal trauma, anesthesiologists must remain vigilant develop a comprehensive anesthetic plan, ensure effective ventilation, and avoid blind tracheal intubation.