Is tracheostenosis sequelae?

summary

I have a colleague who is usually in good health. But these days, I heard from other colleagues that he had tracheal stenosis and needed surgery. I haven't seen him come to work these days. We are all worried about his condition. Yesterday, several of our colleagues went to the hospital to visit him. He had already had an operation. I consulted my doctor and got some information about tracheal stenosis. Let's share it with you.

Is tracheostenosis sequelae?

Subcutaneous emphysema. Subcutaneous emphysema is the most common complication after operation, which is related to excessive separation of soft tissue in front of trachea, short incision outside trachea and long incision inside trachea or tight suture of skin incision. The gas escaping from the trachea cannula can enter the subcutaneous tissue space along the incision and spread along the subcutaneous tissue. The emphysema can reach the head, face, chest and abdomen, but it is generally limited to the neck. Most of them can be absorbed after a few days without special treatment.

Pneumothorax and mediastinal emphysema. When the trachea is exposed, if the trachea is separated too much or too deeply downward, and the pleura is damaged, pneumothorax may be caused. The position of the right pleural apex is higher, especially in children, so the chance of injury is more than that of the left. Mild cases have no obvious symptoms, severe cases can cause asphyxia. If it is found that dyspnea is relieved or disappeared after tracheotomy, and dyspnea occurs again soon, pneumothorax should be considered, and the diagnosis can be confirmed by X-ray. At this time, pleural puncture should be performed to remove the gas. Closed drainage is feasible for severe cases.

Bleeding. If there is a small amount of bleeding in the wound, it can be stopped by compression or by filling gelatin sponge. If there is more bleeding, there may be vascular injury, the wound should be checked and the bleeding point should be ligated.

matters needing attention

Tracheoesophageal fistula. This is a relatively rare situation. When laryngogenic dyspnea occurs, the posterior wall of the trachea and the anterior wall of the esophagus protrude into the lumen of the trachea due to the negative pressure in the trachea. The posterior wall can be damaged when the anterior wall of the trachea is cut. If the fistula is small and the time is not long, sometimes it can heal itself. If the fistula is large or the time is long, and the epithelium has grown into the fistula, it can only be repaired by operation.