Novel tracheal injury management with aortic transection

An 18-year-old driver in a high-speed motor vehicle accident sustained multiple life-threatening injuries, including partial transection of his descending aorta along with a linear tear of the distal trachea. Other significant injuries included closed-head shear injury and multiple bone fractures. Initial presentation revealed a pneumothorax and widening of the mediastinum. Bronchoscopy revealed a long, linear tear of the membranous trachea. Simultaneous exposure of both injuries for repair was not possible. A covered tracheal stent was placed, isolating and sealing the tracheal injury. The aorta was subsequently repaired during cardiopulmonary bypass at a later time. The tracheal stent was removed without sequelae after adequate healing of the membranous tracheal injury.