Journal of the Tennessee Medical Association
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Treatment of a case of traumatic disruption of the cervical trachea has been described. This injury is not common but must be suspected in blunt chest trauma patients, with evidence of possible tracheal obstruction as in this patient. Massive subcutaneous emphysema, large air leaks, and persistent pneumothorax are more common signs of tracheobronchial disruption. Diagnosis can be made with fiberoptic bronchoscopy, and primary repair is the treatment of choice.
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In summary, there are several factors essential to successful treatment of major vascular abdominal injuries. Prompt resuscitation and abdominal exploration is paramount. ⋯ Reimplantation of the injured iliac artery to the contralateral iliac artery is an option for bifurcation injuries if that will not inordinately constrict the lumen. And finally, four-compartment fasciotomies will decompress the lower extremities and prevent ischemic muscle necrosis following reperfusion injury.