CT diagnosis of traumatic bronchial rupture in children

Epelman, Mónica; Ofer, Amos; Klein, Yoram; Best, Leal H.; Guralnik, Ludmila; Bentur, Lea; Traubici, Jeffrey

doi:10.1007/s00247-002-0738-z

Cited by 32 publications

(19 citation statements)

References 16 publications

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“…X-rays and CT scanning may be helpful. Although CT can show the small tears that cannot be seen with bronchoscopy, the best diagnostic method is fiberendoscopy [3,4,8,9]. However, in the emergency situation fiberendoscopy may not be appropriate; this step may be omitted and thoracotomy performed depending on the patient's clinical condition, as with our patient [10].…”

Section: Discussionmentioning

confidence: 82%

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Complete bronchial rupture in a child: report of a case

et al. 2005

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Tracheobronchial rupture due to blunt chest trauma is a rare and serious injury in children. The diagnosis is usually difficult and may be overlooked because of the variability of symptoms and findings. Fiberendoscopy is useful in children with stable tracheal or bronchial ruptures. However, in the emergency situation, fiberendoscopy may not be appropriate, and thoracotomy and primary anastomosis may be the best option.

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Section: Discussionmentioning

confidence: 82%

“…Because symptoms and findings vary depending on the rupture's size and the accompanying lesions, diagnosis is generally delayed, and thus is the major cause of high mortality [2,3]. Fiberendoscopy and a high index of suspicion are the most important factors in diagnosis and management [3,4].…”

Section: Introductionmentioning

confidence: 99%

Complete bronchial rupture in a child: report of a case

et al. 2005

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“…The presence of pneumomediastinum, pneumothorax, or both may thus be suggested. 6,8,10,11 Radiographs of the chest or lateral film of the cervical spine might show a distinct radiolucent shadow along the anterior aspect of the spine, thus indicative of the air beneath the deep cervical fascia. 6,10,11 When a complete transection of the main stem bronchus occurs, the superior margin of the collapsed lung characteristically drops below the level of the transected bronchus, which is called "fallen lung sign."…”

Section: Discussionmentioning

confidence: 98%

Tracheobronchial Rupture due to Blunt Chest Trauma: Report of a Case

et al. 2006

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Tracheobronchial injuries following blunt chest trauma are uncommon in children. The involvement of both the trachea and right main bronchus separately is highly unusual. We herein report the case of a 13-year-old boy who presented with both a tracheal and right main bronchial rupture following blunt chest trauma. While the tracheal laceration required a tracheotomy, a delayed repair of right main bronchial disruption was performed with a complete preservation of the right lung. The features of this uncommon entity are discussed, with special emphasis on early diagnosis and surgical management.

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“…[4] Chest X-ray remains the basic imaging procedure, but some articles have reported cases of traumatic bronchial rupture diagnosed by CT, which has proven helpful in visualizing the level of the rupture. [5,6] Traumatic bronchial injuries in children are usually recognized and repaired immediately, but cases of delayed diagnosis due to the total absence or insignificant clinical symptoms have also been described in the literature. [7] In bronchial injury, when complete disruption occurs, the distal end retracts inferiorly 1 to 4 cm, and within five to seven days, granulations and secretions obliterate the bronchus.…”

Section: Discussionmentioning

confidence: 99%

Rupture of main bronchus due to blunt chest trauma in children: a report of two cases

Bar¹,

Papiashvilli²,

Alzaanin

et al. 2011

Turkish J Thorac Cardiovasc Surg

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Trakeobronşiyal yaralanma künt ya da penetran göğüs travmasından kaynaklanır ve nadir ancak potansiyel olarak ölümcül bir durumdur. Ana bronşun ya da karinanın künt travma nedeniyle rüptüre olması nadir bir durumdur ve çocuklarda en ciddi yaralanmalardan biridir. Bu tip yaralanmanın tanısı güçtür ve yüksek seviyeli klinik şüphe gerektirir. Burada iki total ana bronş rüptürü olgusu sunmaktayız. Bronşiyal rüptürün primer onarımı ilk olguda yaralanmadan iki hafta sonra, ikinci olguda ise yaralanmadan hemen sonra gerçekleştirildi.Anah tar söz cük ler: Bronşlar; karina; çocuk; rüptür; travma.Tracheobronchial injury results from blunt or penetrating chest trauma and is a rare, but potentially fatal condition. Rupture of the main bronchus or carina by blunt trauma is unusual, and it is one of the most severe injuries in children. The diagnosis of this kind of injury is challenging and requires a high degree of clinical suspicion. Here, we report two cases of total rupture of the main bronchus. Primary repair of the bronchial rupture was performed two weeks after the injury in the first case, and immediately after the injury in the second case.Key words: Bronchi; carina; child; rupture; trauma. Tracheobronchial injuries (TBIs) have a high mortality rate unless aggressive treatment is used. In 76% of patients, the injury occurs within 2 cm of the carina and in 43% within the first 2 cm of the right main bronchus.[1] Tracheobronchial injury results from blunt trauma to the thorax and is generally an urgent condition, but sometimes the diagnosis and surgical repair are delayed. The first emergency repair was described by Scannel in 1951.[2] The occurrence of TBI is uncommon in the pediatric trauma population, and total rupture of the airway after blunt trauma is even rarer. [3,4] We present two patients with total rupture of the bronchus who were successfully treated surgically. CASE REPORTCase 1-A six-year-old girl was admitted to a secondary care hospital in Gaza for observation after being thrown to the ground from a moving car. She was conscious on arrival, slightly dyspneic, and pale. A physical examination revealed subcutaneous emphysema in the right chest, and a chest X-ray showed bilateral pneumothorax (Figure 1). Right and left chest tubes were inserted, and a small air leak was demonstrated from the right chest tube only. The girl was hospitalized for further observation. On the fourth day following injury, an X-ray showed a total collapse of the left lung. A computed tomography (CT) scan revealed total atelectasis of the left lung. A pediatric flexible bronchoscopy revealed complete closure of the left main bronchus 1.5-2 cm from the carina. A total rupture of the left main bronchus was suspected, and the patient was transferred to our department two weeks after the injury.On arrival the patient was in good health, slightly tachycardic (120 beats/minute), and pale with blood pressure of 100/60 mm/Hg. Physical examination revealed poor respiratory excursion of the left chest and absence of breath sounds over the ...

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CT diagnosis of traumatic bronchial rupture in children

Cited by 32 publications

References 16 publications

Complete bronchial rupture in a child: report of a case

Complete bronchial rupture in a child: report of a case

Tracheobronchial Rupture due to Blunt Chest Trauma: Report of a Case

Rupture of main bronchus due to blunt chest trauma in children: a report of two cases

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