Journal
FORENSIC SCIENCE MEDICINE AND PATHOLOGY
Volume 17, Issue 3, Pages 481-485Publisher
HUMANA PRESS INC
DOI: 10.1007/s12024-021-00391-z
Keywords
Subglottic stenosis; Trauma; Hypoxia; Cricoid cartilage fracture
Categories
Funding
- National Natural Science Foundation of China [81922041, 82002028]
- Natural science research project of Jiangsu higher education institutions [19KJB340001]
- Shanghai Key Laboratory of Forensic Medicine (Academy of Forensic Science) [KF1906, KF1805]
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This report presents a rare case of delayed subglottic stenosis in a 17-year-old female who suffered severe neck trauma in a car accident. She developed dyspnea 30 days later and eventually died 58 days after the accident due to hypoxic-ischemic encephalopathy and severe pulmonary infection. The postmortem findings revealed tracheal stenosis caused by a cricoid cartilage fracture, fibrous tissue proliferation, and inflammatory cell infiltration.
Delayed subglottic stenosis (SGS) is an unusual complication. Here, we report a particular case of delayed SGS. A 17-year-old female suffered extensive injuries including severe neck trauma in a car accident, and complained of dyspnea after 30 days. Tracheal stenosis was observed by fiber optic bronchoscopy, but no specific treatment was administered to the patient. While being transferred to a tertiary hospital 3 days later, the patient fell into deep coma due to hypoxia, and died of hypoxic-ischemic encephalopathy and severe pulmonary infection in the intensive care unit (ICU) 58 days later. Postmortem autopsy and pathological investigation revealed tracheal stenosis 3.0 cm below the vocal cords with a diameter of 0.5 cm, which was caused by a cricoid cartilage fracture, fibrous tissue proliferation and inflammatory cell infiltration. We believed that external forces caused the cricoid fracture and mucosal damage, and after a month of fibrous repair, scar tissue formed the stenosis and caused her death. This report describes a rare condition in which slowly progressive intralaryngeal stenosis formation after external neck trauma could cause asphyxial death in a previously asymptomatic adult.
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