Wind pipe was completely split, 6 hours marathon surgery performed to reconstruct it
- Cases of Complete tracheal transection is very rare and life threatening
6th August 2021: Doctors at Max Hospital, Vaishali successfully saved the life of 22-year-old Mohammad Irfan who was brutally injured in a road accident with completely split wind pipe and food pipe. Even the minutest delay in intervention would have costed him his life since his oxygen levels were severely low. Conducting a marathon surgery for 6 hours, his trachea (wind pipe) and oesophagus (food pipe) were meticulously reconstructed to give him a new lease of life.
Irfan, who is a resident of Amroha is a healthcare worker, who after completing his emergency room shift in the morning left the hospital around 8:30 AM. While riding back to his home he suddenly got entangled in a thin calibre rope hanging across the street and fell down with excruciating pain in the neck and breathlessness. Passer-by, rushed him to a local hospital where he was provided with first aid. Owing to the severe injury and deteriorating condition, he was referred to Max Hospital Vaishali and was shifted immediately.
Upon arrival at Max Hospital Vaishali, even though the patient was maintaining saturation, but was unable to talk. He underwent an emergency CT scan at the referring hospital which revealed a complete tracheal transection (splitting up of wind pipe into two) with both ends wide apart, which is a very rare injury and life-threatening condition due to complete loss of ventilation.
“Such severe tracheal injuries are usually fatal and many patients never make it to the hospital. But since his split wind pipe formed a pseudo passage of tissue tunnel, maintaining minor ventilation to the lungs, he was lucky to reach the Operating room on time. He was stabilized and taken for surgery at around 9 PM. Since the food pipe was also vertically injured for around 8-10 cm, though blood vessels were intact, the food pipe was repaired first and thereafter the wind pipe was repaired meticulously. The duration of the entire surgery was around 6 hours. The alternate pipes for food and air were also put in simultaneously to let the repair heal. The patient was bought to consciousness and shifted to ICU thereafter. He was shifted to normal room after two days in ICU.” Said Dr Pramoj Jindal, Director – Thoracic Surgery, Max Hospital, Vaishali.
Post operatively the patient was monitored closely and after a week, video bronchoscopy revealed that the repair was fine, and was discharged to home next day.
One of the major reasons that Irfan’s life was saved is due to the improved territorial connectivity that he was able to reach a well-equipped hospital (Max Hospital Vaishali) in a much shorter time.
Successful management requires emergent evacuation of the injured to a trauma care centre for stabilisation and a quick, safe and efficient transfer to a centre where definitive surgical management (tracheal reconstruction in this case) can be undertaken at the earliest. This rare case exemplifies the successful management of airway trauma where each step was carried out in the recommended manner leading to a successful outcome.
“The patient who is recovering well, is under speech therapy and regular training to get his voice back. While looking at the entire situation, the patient may take another 2-3 months to get his voice back and regular swallowing pattern, but something of a very insignificant time, seeing him alive and healthy.” He added
