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Bronchial injuries: a tale of differing presentations

  • Niraj Maskey
  • Ranjan Sapkota
  • Bibhusal ThapaEmail author
Case Report
  • 2 Downloads

Abstract

Bronchial disruptions are uncommon but nevertheless grievous injuries and are usually secondary to major thoracic trauma. Although many are associated with other catastrophic injuries causing early mortality, their presentations can be late and they are often difficult to diagnose. Their management is frequently challenging and the ideal course of treatment is not yet clearly defined. Here, we describe two cases of main bronchial injuries presenting to us with post-traumatic collapse lung, albeit with a widely differing post-trauma course. Both required thoracotomy followed by a resection and anastomosis of the disrupted/stenotic segment. Operative results were good with both cases showing a well-expanded lung and no postoperative anastomotic site stenosis during the period of follow-up. Our experience highlights that patients with major bronchial injuries can have varying presentations. High degree of suspicion is necessary for early diagnosis and prompt surgical treatment. Resection of the stenosed/fibrosed segment followed by anastomosis yields good results.

Keywords

Blunt thoracic trauma Bronchial injuries Pneumonectomy 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Disclaimers

Nil.

References

  1. 1.
    Palade E, Passlick B. Surgery of traumatic tracheal and tracheobronchial injuries. Chirurg. 2011;82:141–7.CrossRefGoogle Scholar
  2. 2.
    Zhao Z, Zhang T, Yin X, Zhao J, Li X, Zhou Y. Update on the diagnosis and treatment of tracheal and bronchial injury. J Thorac Dis. 2017;9:E50–6.CrossRefGoogle Scholar
  3. 3.
    Glazer ES, Meyerson SL. Delayed presentation and treatment of tracheobronchial injuries due to blunt trauma. J Surg Educ. 2008;65:302–8.CrossRefGoogle Scholar
  4. 4.
    Chu CP, Chen PP. Tracheobronchial injury secondary to blunt chest trauma: diagnosis and management. Anaesth Intensive Care. 2002;30:145–52.Google Scholar
  5. 5.
    Kurgansky IS, Makhutov VN, Lepekhova SA. The methods for the treatment and prevention of cicatrix stenoses of trachea. Vestn Otorinolaringol. 2016;81:66–71.CrossRefGoogle Scholar
  6. 6.
    Glinjongol C, Pakdirat B. Management of tracheobrochial injuries: a 10-year experience at Ratchaburi hospital. J Med Assoc Thail. 2005;88:32–40.Google Scholar
  7. 7.
    Dowd NP, Clarkson K, Walsh MA, Cunningham AJ. Delayed bronchial stenosis after blunt chest trauma. Anesth Analg. 1996;82:1078–81.Google Scholar
  8. 8.
    Madden BP, Loke TK, Sheth AC. Do expandable metallic airway stents have a role in the management of patients with benign tracheobronchial disease? Ann Thorac Surg. 2006;82:274–8.CrossRefGoogle Scholar
  9. 9.
    Ozdulger A, Cetin G, Erkmen Gulhan S, Topcu S, Tastepe I, Kaya S. A review of 24 patients with bronchial ruptures: is delay in diagnosis more common in children? Eur J Cardiothorac Surg. 2003;23:379–83.CrossRefGoogle Scholar
  10. 10.
    Karmy-Jones R, Wood DE. Traumatic injury to the trachea and bronchus. Thorac Surg Clin. 2007;17:35–46.CrossRefGoogle Scholar

Copyright information

© Indian Association of Cardiovascular-Thoracic Surgeons 2019

Authors and Affiliations

  1. 1.Manmohan Cardio-thoracic Vascular and Transplant Centre, Institute of MedicineTribhuvan UniversityKathmanduNepal

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