Tracheal Rupture Diagnosed with Virtual Bronchoscopy and Managed Nonoperatively: A Case Report

Nonoperative Management of Tracheobronchial Injuries in Severely Injured Patients

“…However, TBR cannot be ruled out using CT alone when it is suspected on the basis of clinical and radiological findings. In such patients, bronchoscopy remains the gold standard and should be performed owing to the high incidence of mortality and morbidity of misdiagnosed injuries, 4,13 Nakamori et al 19 reported a case where a tracheal rupture was diagnosed using virtual bronchoscopy based on the technical parameters of a multidetector helical CT scanner for reconstruction of a three-dimensional image. This technique may be a useful and less invasive tool for diagnosis in patients with suspected tracheal injury, but there is still a lack of sufficient data at present.…”

“…For these patients, aggressive operative management and surgical repair may not pose a very high risk, despite the fact that mortality is high and some patients still die because of other injuries such as severe traumatic brain injury. 1,3,5,7,19 Ramzy et al 29 reviewed their clinical experiences in the management of bronchial and intrathoracic tracheal injuries in patients with multiple system trauma and reported on a series of eight patients who were all managed operatively. In four of five cases, a celiotomy was performed before thoracotomy because of hemodynamic instability with evidence of significant ongoing abdominal bleeding.…”

“…In cases where cardiopulmonary bypass is needed to provide adequate ventilatory or circulatory support, the risks of heparinization must be weighed against potential benefits. 19 Bleeding from other organs or intracerebral injuries may worsen the patient's prognosis and outcome.…”

Conservative management of tracheal rupture in a child after blunt trauma

“…5 Kaloud et al recommended surgical repair in ruptures with a length exceeding 1cm. 6 Kuhne et al, Merol et al and D'Odement et al reported successful conservative treatment of tracheal lesions.…”

Abordaje conservador de una rotura traqueal en un niño tras una contusión

“…5 Kaloud y col. recomendaron la reparación quirúrgica de las roturas de más de 1 cm de largo. 6 Kuhne y col., Merol y col. y D'Odement y col. informaron sobre el éxito del abordaje conservador de las lesiones de la tráquea.…”