# Successful Treatment of Multilevel Tracheal Stenosis Post Blunt Chest Trauma in a Child by Early Bronchoscopic Balloon Dilatation: A Case Report

## TL;DR

A child with tracheal stenosis after a car accident was successfully treated with early bronchoscopic balloon dilatation, preventing long-term complications.

## Contribution

This case report highlights the successful use of early bronchoscopic balloon dilatation for treating multilevel tracheal stenosis in a child.

## Key findings

- The child showed sustained improvement in symptoms and spirometry after repeated bronchoscopic balloon dilatation.
- Early recognition and treatment prevented long-term complications of tracheal stenosis.
- Multilevel tracheal stenosis was confirmed via direct laryngoscopy and bronchoscopy.

## Abstract

Background: Tracheal stenosis in children is a rare but potentially life-threatening condition. We report a case of multilevel tracheal stenosis in a child who sustained blunt chest trauma in a car accident. Case Presentation: The patient is an 11-year-old previously healthy boy who presented to the pediatric emergency room unconscious after being rolled over while seated unstrained inside a vehicle. A chest CT scan showed bilateral pulmonary contusions. He required intubation and mechanical ventilation initially but was noted to have biphasic stridor after extubation. He presented to the pediatric pulmonary clinic 2 weeks after discharge from the hospital with persistent stridor and shortness of breath on exertion. Spirometry revealed flattening of the inspiratory and expiratory limbs of the flow-volume loop, suggestive of fixed large airway obstruction. Direct laryngoscopy and bronchoscopy were performed and revealed multilevel tracheal stenosis. He was successfully treated with repeated bronchoscopic balloon dilatation with sustained improvement in symptoms and spirometry findings 8 months post final procedure. Conclusion: Tracheal stenosis should be suspected in children who sustain blunt chest trauma. Early recognition and treatment with bronchoscopic balloon dilatation can prevent long-term complications.