New GSW case

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Hello all — I have a case I'd like your opinions on:

11 y.o female, 60kg. Sustained a GSW ( .380 handgun) directly through
and through the trachea and spinal cord. Spinal injury is complete at T3
— fairly straightforward.

The tracheal injury consists of two very clean holes directly anterior
and posterior (I will admit to having perc. trachs less perfectly
placed) at 4-5 cm above the carina. There was minimal mediastinal air on
the CT, no esophageal or great vessel injury (Ba swallow and CT angio
respectively). The patient is temporarily intubated past the injury (via
bronchoscopy) and sedated in the PICU.

Does it have to be fixed or can it be managed non-operatively with
temporary intubation?


Thanks,
Bill

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