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Case Reports
. 2024 Jan:114:109173.
doi: 10.1016/j.ijscr.2023.109173. Epub 2023 Dec 19.

Combined tracheoesophageal transection following a life-threatening clothesline-type blunt neck trauma: A case report

Ramin Ebrahimian  1 , Maziar Moayerifar  2 , Mahboobeh Gholipour  1 , Maede Mohammadian  3 , Mani Moayerifar  4
Affiliations
Case Reports

Combined tracheoesophageal transection following a life-threatening clothesline-type blunt neck trauma: A case report

Ramin Ebrahimian et al. Int J Surg Case Rep. 2024 Jan.

Abstract

Introduction: Blunt neck trauma is an uncommon, life-threatening injury that may result in tracheoesophageal transection. The manifestations of these traumas are rather vague and nonspecific; therefore, the injury may be missed, if a careful attention is not paid.

Case presentation: A 23-year-old young man presented with complete transection of the trachea and concurrent esophageal injury, caused by clothesline-type blunt neck trauma, while riding a motorcycle. On early examination, the patient was hemodynamically stable; however, after a few minutes, he manifested respiratory distress and progressive subcutaneous emphysema. The airway immediately was secured by inserting an endotracheal tube in distal part of the transected trachea. Afterward, the patient underwent primary repair of transected trachea and esophagus, and tracheostomy. The post-operative period was uneventful.

Discussion: The blunt traumas to neck, which lead to complete transection of the trachea and the esophagus, are rare injuries. Clothesline-type injuries are the principal reasons for cricotracheal separation and further esophageal injuries. In most cases, subcutaneous emphysema is a sign of significant trauma to the aerodigestive tract. After securing the patient's airway, early surgical repair of the transected trachea and esophagus reduces the risk of further complications.

Conclusion: This report discusses a rare, life-threatening presentation of blunt neck trauma called clothesline-type injury, that led to complete transection of the trachea and concurrent esophageal rupture. Establishing a secure airway for those patients with tracheal injuries is required. Repairing the injured trachea and esophagus primarily at the earliest possible time can improve the patient prognosis and prevent further complications.

Keywords: Case report; Clothesline-type trauma; Esophageal injury; Tracheal transection.

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Conflict of interest statement

Declaration of competing interest There are none to declare.

Figures

Fig. 1
Fig. 1
Intraoperative photograph of surgical field: (A) Complete transected trachea (B) Black arrow indicating transected trachea, white arrow indicating ruptured esophagus, and yellow arrow indicating NG tube inserted in the esophagus (C) Approximation two ends of the transected trachea using interrupted absorbable suture (D) After primary repair of the transected trachea. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
Fig. 2
Fig. 2
One week post-operative esophagography: No signs of aspiration or leakage are noticed.
See this image and copyright information in PMC

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