Background: Tracheobronchial disruption as a result of blunt thoracic trauma is a rare entity and only clinically serious lesions come to our notice, which can be life-threatening and need prompt recognition and treatment. Objectives: To review the authors' experience with tracheobronchial injuries to emphasize the need for prompt diagnosis and treatment to avoid lethal complications including severe hypoxic organ failure, sepsis, mediastinitis and bronchopleural fistula. Patients and methods: A retrospective study of total 32 patients with tracheobronchial injury from 2001 to 2011. This study limited to patients with thoracic tracheal or bronchial injury, excluding those with cervical injuries. The study includes collected information about mechanism of injury, presentation, time until diagnosis and treatment, anatomical site of injury, type of treatment, diagnostic methods, duration of follow up and outcome. Results: Twenty-four patients were male (75%) and eight were females (25%). Patient's ages ranged from 7-53 years. Majority of cases was referred because of blunt trauma in 15 cases (46.8%), 6 (18.75) motor vehicle accident, 5 (15.6%) fall from a height and 4 (12.5%) with trauma by heavy object, while 8 cases (25%) were referred due to penetrating injury and 2 cases (6.25%) due to iatrogenic injury. In initially diagnosed group, the predominant clinical signs that give a suspicion of tracheobronchial disruption were increased subcutaneous surgical emphysema, shortness of breath, hemoptysis. After the admission to emergency unit, all of them were examined radiologically by chest X-ray film. Longitudinal tear of right upper lobe bronchus was found in 8 cases (32%), complete cut of right upper lobe bronchus in 4 cases (16%), tear of right intermediate bronchus in 4 cases (16%), 3 cases with clear cut left upper lobe (12%), longitudinal tear of distal lateral tracheal wall extend to right upper lobe in 2 cases (8%), 2 cases (8%) showed complex disruption of distal trachea right main with carinal tear and 2 cases (8%) with longitudinal tear of membranous wall of the trachea. 17 patients from early diagnosed cases had concomitant comorbid extra thoracic injuries at the time of diagnosis in the form of abdominal trauma in 12 cases, skeletal fractures in 9 cases and head injury in 5 cases. Conclusion: In a patient with a complex bronchial rupture, primary repair of the bronchus can be possible with complete functional preservation of the lung tissue.
This study investigates and analyzes the effect of flux intensification due to the propeller shaft and rudder on the 3D mapped induced magnetic signature of marine vessels. The study was designed to extrapolate the 3D induced magnetic signature and to analyze the difference between signature components in two different cases: a vessel without propeller shaft or rudder and a vessel with the propeller shaft and rudder attached. Numerical modeling was conducted using full-scale vessel dimensions and finiteelement analysis (FEA) modeling software. Measurements on a 1:100 properly scaled and designed physical scale model (PSM) were conducted in a magnetically clean area. To enrich the analysis, both signature components from the numerical evaluation and experimental measurements were 3D mapped. Both the scaling technique and scaling effect on magnetic signature were investigated. The signature measurements of the scaled vessel model were performed to verify the numerical model. Both the numerical and experimental results are both discussed and shown to be consistent. The extrapolated signature components revealed that the studied effect became prominent as the saliency of the 3D mapped signature components increased. Consequently, this effect increases the magnetic susceptibility of the vessel to detection or destruction. Finally, this study suggests solutions to reduce this effect.
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