Laryngotracheal separation after attempted hanging.

The successful management of a 29-yr-old patient with tracheal separation between rings one and two after attempted hanging is described. Increasing difficulty with ventilation via a tracheal tube and surgical emphysema indicated the need for a tracheostomy. The diagnosis was made during the tracheostomy procedure when it was observed that the tracheal tube was protruding through the incomplete transection of the trachea such that Murphy's eye was aligned with the lower tracheal stump. The patient underwent primary anastomosis of the trachea with placement of a Lorenz tracheal stent. On subsequent follow-up he had evidence of damage to both recurrent laryngeal nerves. The signs and symptoms of laryngotracheal separation after blunt trauma are described. A review of the airway management has been made as it requires combined anaesthetic and surgical expertise. Injuries to the trachea may have severe, life-threatening consequences and early diagnosis and management reduce morbidity and mortality.