A Hidden Airway Injury: Delayed Diagnosis of Tracheal Disruption After Penetrating Neck Trauma.

Tracheobronchial injury is a rare but potentially life-threatening complication of both blunt and penetrating chest trauma. Early recognition is critical, as a delayed diagnosis is associated with increased morbidity and mortality. This case report highlights a rare and potentially fatal tracheobronchial injury encountered following a motor vehicle collision (MVC). The patient sustained penetrating thoracic trauma secondary to guardrail intrusion, resulting in an injury to the carina with associated respiratory compromise requiring emergent chest tube placement. During operative exploration, disruption of the carinal region was identified and subsequently managed with definitive surgical repair. The patient ultimately survived and had an uncomplicated postoperative recovery. This case highlights the importance of maintaining a high index of suspicion for traumatic airway injuries, as early recognition and timely operative intervention are critical to optimizing outcomes.