Tracheobronchial injury due to blunt chest trauma

Abstract

Tracheobronchial avulsion resulting from blunt trauma is a very rare and serious condition, mostly due to high-speed traffic crashes. In this article, we briefly report the case of an 18-year-old man who was injured in a car accident and because of massive persistent air leakage (despite appropriate chest tube drainage), deemed to have a deep tracheobronchial injury. Due to a rapid drop in the patient's O2 saturation, he underwent an anterolateral thoracotomy. Endotracheal intubation was performed under direct visualization. The right mainstem bronchus was disrupted from the carina with a 1.5-cm stump remaining on the carina, and the remainder was crushed to the origin of the right superior lobe bronchus. Hence, a right superior lobectomy was performed and the postoperative course was uneventful.

Concomitant Avulsion Injury of the Subclavian Vessels and the Main Bronchus Caused by Blunt Trauma

“…Cases of tracheobronchial avulsion or subclavian vessel injury have been described [ 1 , 2 ]; however, no case of concomitant bronchial avulsion and subclavian vessel injury from blunt chest trauma has yet been reported. This type of injury from blunt trauma to the thorax is rare, and is caused by neck hyperextension along with the movement of the heart movement to pressure between the sternum and thoracic vertebrae [ 1 ].…”

“…A bronchial injury is suspected when continuous air leakage is present. Bronchial injuries are diagnosed through bronchoscopy, and CT scans can localize the level of the rupture [ 2 , 3 ]. In this case, the bronchial injury could not be found due to severe swelling of the mediastinal tissue, and bronchial patency was observed on the first CT scan.…”