Penetrating Tracheal injury- A surgical challenge
Direct tracheal injury is a rare injury, accounting for less than 1% of traumatic injury and 14% of penetrating neck injuries.
(1,2) Majority of such cases are seen in zone II of the Neck that is from cricoid cartilage to the angle of mandible. (1,3) These injuries occur most commonly from assault with sharp objects like knife, scissor and ballistic injuries. (1) Surgical exploration is a major challenge for surgeons due to dense arrangement of vital structures which cannot be examined or assessed by
physical examination. (3) In neck injuries the management
should be within the golden hour to prevent aspiration of
blood through the tracheal opening. Here we are reporting surgically treated two cases of anterior tracheal injury following assault with knife.

Case Report
Within 3 months we got two cases of Penetrating
cervical injury in Emergency Department of Subharti Hospital and University. In first case a 35year male presented with
respiratory distress, altered sensorium and bleeding from neck wound. Patient had an alleged history of self - inflicted injury from knife after some family feud. Pulse was 130/min and B.P. was 90/60 mm of Hg. SpO2 was 88% at the time of admission. On examination size of wound was around 4x1cm. Wound was about 1cm above the thyroid cartilage. Blood and air during expiratory phase were coming from the wound site....