Cervical tracheal transection after scarf entanglement in a go-kart engine.

BACKGROUND Tracheal disruption secondary to blunt force occurs infrequently. Most individuals suffering such an injury die before arriving at a hospital. Diagnosis for those who do present alive is often delayed, as signs and symptoms typically do not match the severity of injury. OBJECTIVE The objectives of this case report are to present a unique mechanism for tracheal disruption and to discuss our management strategy. CASE REPORT We describe an 18-year-old man who suffered tracheal disruption after entanglement of his scarf in a go-kart engine. His initial workup was conducted by emergency physicians and included computed tomographic evaluation of the neck. After diagnosis, the patient was transported to an operating suite. Awake tracheostomy was performed in this controlled environment to secure the airway, after which the trachea was repaired via primary anastomosis. CONCLUSIONS Prompt recognition and appropriate intervention are critical in the care of patients with suspected tracheal transection to prevent mortality.