Abstracts
Chest injuries, both blunt and penetrating, are common and are responsible for at least a quarter of the mortalities seen in trauma patients. These injuries are diverse, encompassing the entirety of the respiratory tract from the trachea to the lungs. Tracheobronchial injuries most often lead to airway compromise and necessitate emergent surgical intervention to restore airway continuity. Although rare, tracheobronchial injuries are often fatal and even when timely managed are not uncommonly associated with anastomotic complications. The much more common pulmonary injuries include pneumothorax, hemothorax, and parenchymal injury. Although often managed nonoperatively, patients with pulmonary injuries may require surgical interventions to excise unsalvageable lung tissue, restore hemodynamic stability in cases of massive hemothorax, or evacuate retained blood clots. This chapter provides an overview of the common presentation and necessary diagnostic procedures for an accurate assessment of patients with tracheal and pulmonary injury. Furthermore, it describes the appropriate management for such patients and the complications that may arise.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Kummer C, Netto FS, Rizoli S, Yee D. A review of traumatic airway injuries: potential implications for airway assessment and management. Injury. 2007;38(1):27–33.
Kiser AC, O’Brien SM, Detterbeck FC. Blunt tracheobronchial injuries: treatment and outcomes. Ann Thorac Surg. 2001;71(6):2059–65.
Symbas PN, Justicz AG, Ricketts RR. Rupture of the airways from blunt trauma: treatment of complex injuries. Ann Thorac Surg. 1992;54(1):177–83.
Oh KS, Fleischner FG, Wyman SM. Characteristic pulmonary finding in traumatic complete transection of a main-stem bronchus. Radiology. 1969;92(2):371–2.
Matsushima K, Aiolfi A, Park C, Rosen D, Strumwasser A, Benjamin E, et al. Surgical outcomes after trauma pneumonectomy: revisited. J Trauma Acute Care Surg. 2017;82(5):927–32.
Wright CD, Grillo HC, Wain JC, Wong DR, Donahue DM, Gaissert HA, et al. Anastomotic complications after tracheal resection: prognostic factors and management. J Thorac Cardiovasc Surg. 2004;128(5):731–9.
Altinok T, Can A. Management of tracheobronchial injuries. Eurasian J Med. 2014;46(3):209.
Soult MC, Weireter LJ, Britt RC, Collins JN, Novosel TJ, Reed SF, et al. Can routine trauma bay chest x-ray be bypassed with an extended focused assessment with sonography for trauma examination? Am Surg. 2015;81(4):336–40.
Rodriguez RM, Canseco K, Baumann BM, Mower WR, Langdorf MI, Medak AJ, et al. Pneumothorax and hemothorax in the era of frequent chest computed tomography for the evaluation of adult patients with blunt trauma. Ann Emerg Med. 2019;73(1):58–65.
Laan DV, Vu TDN, Thiels CA, Pandian TK, Schiller HJ, Murad MH, et al. Chest wall thickness and decompression failure: a systematic review and meta-analysis comparing anatomic locations in needle thoracostomy. Injury. 2016;47(4):797–804.
Bauman ZM, Kulvatunyou N, Joseph B, Jain A, Friese RS, Gries L, et al. A prospective study of 7-year experience using percutaneous 14-French pigtail catheters for traumatic hemothorax/hemopneumothorax at a level-1 trauma center: size still does not matter. World J Surg. 2018;42(1):107–13.
Karmy-Jones R, Jurkovich GJ, Nathens AB, Shatz DV, Brundage S, Wall MJ, et al. Timing of urgent thoracotomy for hemorrhage after trauma: a multicenter study. Arch Surg. 2001;136(5):513–8.
Asensio JA, Ogun OA, Mazzini FN, Perez-Alonso AJ, Garcia-Núñez LM, Petrone P. Predictors of outcome in 101 patients requiring emergent thoracotomy for penetrating pulmonary injuries. Eur J Trauma Emerg Surg. 2018;44(1):55–61.
Michelet P, Couret D, Brégeon F, Perrin G, D'Journo X-B, Pequignot V, et al. Early onset pneumonia in severe chest trauma: a risk factor analysis. J Trauma Acute Care Surg. 2010;68(2):395–400.
DuBose J, Inaba K, Okoye O, Demetriades D, Scalea T, O’Connor J, et al. Development of posttraumatic empyema in patients with retained hemothorax: results of a prospective, observational AAST study. J Trauma Acute Care Surg. 2012;73(3):752–7.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Stewart, C., Chehab, M., Joseph, B. (2022). Tracheal and Pulmonary Injury. In: Shiroff, A.M., Seamon, M.J., Kaplan, L.J. (eds) Management of Chest Trauma. Springer, Cham. https://doi.org/10.1007/978-3-031-06959-8_17
Download citation
DOI: https://doi.org/10.1007/978-3-031-06959-8_17
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-06958-1
Online ISBN: 978-3-031-06959-8
eBook Packages: MedicineMedicine (R0)