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Sección traqueal completa por traumatismo cervical cerrado
Complete tracheal resection in closed cervical spine injury
Carmen María Rodríguez Gómez
, Matilde Rubio Garay, Xavier Baldó Padró
Corresponding author
Servicio de Cirugía Torácica, Hospital Josep Trueta, Girona, España
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Cirugía Torácica, Hospital Josep Trueta, Girona, España" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Complete tracheal resection in closed cervical spine injury" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1341 "Ancho" => 3001 "Tamanyo" => 352807 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) Corte axial de la TAC. B) Corte sagital de la TAC. C) Imagen quirúrgica con intubación distal intraoperatoria.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Paciente varón de 17 años, con traumatismo cervical cerrado por accidente de tráfico, estable hemodinámicamente, presentando desaturaciones continuas que obligaron a intubación orotraqueal. En nuestro centro se realiza TAC, observándose rotura traqueal/cervical completa con dehiscencia de 5<span class="elsevierStyleHsp" style=""></span>cm de cabo proximal a distal y localización del tubo orotraqueal en mediastino (<a class="elsevierStyleCrossRef" href="#fig0005">figs. 1A y B</a>). Ante estos hallazgos, se decide realizar cirugía con carácter urgente, mediante cervicotomía transversa anterior con intubación intracampo (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a><span class="elsevierStyleSmallCaps">C</span>) y anastomosis traqueal término-terminal con traqueotomía distal de descarga. El paciente es extubado al tercer día del postoperatorio, y dado de alta al noveno día tras la intervención, con retirada de la cánula de traqueotomía, y el cierre de la misma al comprobar la permeabilidad de la vía aérea e ingesta digestiva adecuada. Tras 6 meses persiste disfonía por parálisis de ambas cuerdas vocales en posición paramedial.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">La rotura traqueal completa causada por traumatismos cervicales cerrados de alto impacto son lesiones raras<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a>, con una incidencia aproximada del 1%, pero potencialmente mortales que precisan de un diagnóstico y de un manejo terapéutico inmediato<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a>. La función fonatoria y respiratoria pueden verse comprometidas por una paresia o una parálisis de cuerdas vocales causada por avulsión neurológica recurrencial uni o bilateral.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1341 "Ancho" => 3001 "Tamanyo" => 352807 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) Corte axial de la TAC. B) Corte sagital de la TAC. C) Imagen quirúrgica con intubación distal intraoperatoria.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tracheal and bronchial rupture after blunt thoracic trauma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L. Swoboda" 1 => "H. Walz" 2 => "R. Kirchner" 3 => "H. Wertzel" 4 => "J. Hasse" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Zentralbl Chir" "fecha" => "1993" "volumen" => "118" "paginaInicial" => "47" "paginaFinal" => "52" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8451888" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Complete disruption of the trachea due to blunt neck trauma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T. Yamanda" 1 => "T. Aoki" 2 => "K. Kaneko" 3 => "M. Miyazawa" 4 => "K. Yoshida" 5 => "M. Haniuda" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Nihon Kyobu Geka Gakkai Zasshi" "fecha" => "1995" "volumen" => "43" "paginaInicial" => "543" "paginaFinal" => "546" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7608610" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:3 [ "titulo" => "Agradecimientos" "texto" => "<p id="par0015" class="elsevierStylePara elsevierViewall">Al Dr. Tobed del Servicio de Otorrinolaringología del Hospital Josep Trueta, por su colaboración en la intervención quirúrgica y posterior seguimiento conjunto del paciente.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005200000012/v1_201611260110/S0300289616000326/v1_201611260110/es/main.assets" "Apartado" => array:4 [ "identificador" => "45361" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imagen clínica" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005200000012/v1_201611260110/S0300289616000326/v1_201611260110/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616000326?idApp=UINPBA00003Z" ]
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