Traumatic tension pneumopericardium and amputation of the left main bronchus (original) (raw)

Right main bronchial disruption due to blunt trauma

Journal of the College of Physicians and Surgeons Pakistan Jcpsp, 2009

A young soldier was crushed between two vehicles sustaining severe injury to right side of chest leading to multiple rib fractures, tension pneumothorax, bronchopleural fistula, and later on gross surgical emphysema. Rigid bronchoscopy confirmed injury to right upper bronchus. Surgical repair and postoperative care of such a major, although rare, injury was successfully achieved in this small hospital by a team augmented by a specialist from thoracic surgery centre. The risks of transport of a major thoracic injury should be assessed against a possible definitive treatment locally. Fibreoptic or rigid bronchoscopy should be employed as early as possible in all suspected cases of major airways injury. An outreach service by a thoracic surgery centre can be life-saving.

Traumatic rupture of the bronchus intermedius in closed chest trauma

Medicinski arhiv, 2008

Traumatic rupture of the major intrathoracic airway following blunt thoracic trauma is a potentially lethal injury which can be repaired successfully if the diagnosis is made early. Early repair of the bronchus will ensure a good anatomic result and almost complete return of pulmonary function. This article describes the situation in a patient with complete transversal and partial longitudinal rupture of the bronchus intermedius after car accidents. Bronchus injury was repaired primarily with uneventful recovery.

Right main bronchus rupture associated with blunt chest trauma: a case report

International Journal of Emergency Medicine

Background Tracheobronchial injury is one of the least common injuries in the scenario of blunt chest trauma. However, around 81% of patients with airway injury die immediately or before arriving at the emergency department due to tension pneumothorax. It presents with non-specific signs and symptoms challenging prompt diagnosis. Case presentation A 15-year-old adolescent who was riding a bicycle suffered an accident when he fell down a cliff, approximately 5 m deep. Upon admission to the emergency department, he presented with signs of respiratory distress. The airway was secured and a thoracoabdominal angiography was performed. The image reported pneumomediastinum, a small right pneumothorax, areas of pulmonary contusion, and an image of loss of continuity in the anterior superior wall of the right main bronchus highly suggestive of bronchial rupture. The bronchial lesion was then confirmed by fiberoptic bronchoscopy. Taking into account the patient’s characteristics, conservative...

Bronchial injuries: a tale of differing presentations

Indian Journal of Thoracic and Cardiovascular Surgery, 2019

Bronchial disruptions are uncommon but nevertheless grievous injuries and are usually secondary to major thoracic trauma. Although many are associated with other catastrophic injuries causing early mortality, their presentations can be late and they are often difficult to diagnose. Their management is frequently challenging and the ideal course of treatment is not yet clearly defined. Here, we describe two cases of main bronchial injuries presenting to us with post-traumatic collapse lung, albeit with a widely differing post-trauma course. Both required thoracotomy followed by a resection and anastomosis of the disrupted/ stenotic segment. Operative results were good with both cases showing a well-expanded lung and no postoperative anastomotic site stenosis during the period of follow-up. Our experience highlights that patients with major bronchial injuries can have varying presentations. High degree of suspicion is necessary for early diagnosis and prompt surgical treatment. Resection of the stenosed/fibrosed segment followed by anastomosis yields good results.

Combined ascending aorta rupture and left main bronchus disruption from blunt chest trauma

The Annals of Thoracic Surgery, 1989

After blunt chest trauma, early diagnosis of associated bronchial, vascular, and esophageal injuries must be attempted, as those lesions may be produced by the same mechanism. We report a case of successful management of associated bronchial transection and injury of the ascending aorta. Aortic repair required cardiopulmonary bypass and the use of prosthetic materials, although racheobronchial injuries as a result of blunt chest T trauma are rare (3% in an autopsy study [l] compared with 18% for injuries of the thoracic aorta and its branches). As far as we know, only 4 cases of successful treatment of a rupture of the ascending aorta have been reported [24]. We report what is, to our knowledge, the second case of combined ascending aorta and left main bronchus injury from blunt chest trauma, with special emphasis on the importance of early diagnosis and treatment of such associated lesions.

Posttraumatic disruption of the right main bronchus - a case report

Medical review

Introduction. Tracheobronchial disruption is a rare disorder, usually accompanied by a severe blunt chest trauma that quite rarely appears as an isolated event. Case Report. This is a case report of a right main bronchus disruption, due to an injury to the right hemithorax, caused by a falling tree trunk. The disruption was accompanied by mediastinal emphysema, fractures of the 4th and 5th ribs on the right side and compound sternal fracture. The patient was operated in general anesthesia, through right thoracotomy approach, followed by successful right main bronchus reconstruction by interrupted suture technique, without anatomic resection of the lung parenchyma. Conclusion. Although this injury is rare, with suspicion of bronchial rupture, bronchoscopy confirms the diagnosis and leads to better prognosis.

Left main bronchus separation after blunt trauma

Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery, 2017

Tracheobronchial damage is very rare in clinical practice and represents no more than 1% of all injuries caused by blunt trauma. Nearly 80% of patients die before reaching the hospital. Most ruptures are observed in the right main bronchus and are located within 2 cm of the carina trachea. The highest mortality rate applies to patients with bilateral bronchial injuries. Nonspecific symptoms, additionally masked by complaints regarding other damaged organs, delay the diagnosis and surgical treatment. The aim of this article is to present one particular clinical case and to discuss it in conjunction with a literature review.