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Mon Mar 16 15:45:30 GMT 2009

You should also try Hyaluronic acid (HA). It has shown successful in treating tracheal injuries and in post-op. HA is essential in preventing tracheal stenosis.

Just a thought,
D. R. Gill
Mercer University

--- On Mon, 3/16/09, kmattox at aol.com <kmattox at aol.com> wrote:

From: kmattox at aol.com <kmattox at aol.com>
Subject: Re: New GSW case
To: "Trauma & Critical Care mailing list" <trauma-list at trauma.org>
Date: Monday, March 16, 2009, 10:42 AM

Concerned that there IS an esophageal injury still.  Did you use gastrograffin
or Barium. Barium is preferred.  A negative esophageal swallow does not rule out
an injury.   This patient will need a permanent tracheostomy.   
------Original Message------
From: William Bromberg
Sender: 
To: trauma-list at trauma.org
ReplyTo: Trauma &amp; Critical Care mailing list
Sent: Mar 16, 2009 9:32 AM
Subject: New GSW case

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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New GSW case