Skip to main content
SpringerLink
Log in

Tracheobronchial rupture in a child following blunt trauma

  • Case Report
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

A 6-year-old boy sustained a crush injury to the upper chest that resulted in a linear laceration of the membranous part of the lower trachea and right main stem bronchus. He presented with extensive subcutaneous emphysema, pneumomediastinum, and pneumoperitoneum. The diagnosis was indicated by a CT scan of the chest and confirmed by bronchoscopy. The trachea was intubated in the operating room after rigid bronchoscopy. Intraoperative leakage of gas from the tracheobronchial laceration was minimized by single left-lung manual ventilation and application of moist packs to the site of tracheal injury. Surgical repair was achieved with interrupted sutures of non-absorbable material; a pedicle pleural flap was used to buttress the suture line. The patient was discharged in good condition after 1 week. Complete healing of the anastomosis was attested at bronchoscopy 2 months postoperatively. The rarity of tracheobronchial lacerations in childhood is noted on review of the literature. Emphasis is placed on early recognition and expeditious management of tracheobronchial lacerations. Rarely, these lacerations have been reported to heal spontaneously.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Barnhart GR, Brooks JW, Kellum JM (1986) Pneumoperiotoneum resulting from tracheal rupture following blunt chest trauma. J Trauma 26: 486–488

    Google Scholar 

  2. Baumgartner F, Sheppard B, de Virgilio C, et al (1990) Tracheal and main bronchial disruptions after blunt chest trauma: presentation and management. Am Thorac Surg 50: 569–574

    Google Scholar 

  3. Bickford BJ (1962) Chest injuries in childhood and adolescence. Thorax 17: 240–243

    Google Scholar 

  4. Danis RK, Schweiss JF (1976) Late repair of bronchial rupture in a child by bronchial replantation. J Pediatr Surg 11: 235–238

    Google Scholar 

  5. Dreyfuss D, Jackson RS, Coffin LH, et al (1986) High frequency ventilation in the management of tracheal trauma. J Trauma 26: 287–289

    Google Scholar 

  6. Edwards WH, Morris JA, De Lozier JB, et al (1987) Airway injuries. Am Surg 53: 192–197

    Google Scholar 

  7. Eijgelaer A, Homen van der Heide JN (1970) A reliable early symptom of bronchial or tracheal rupture. Thorax 25: 116

    Google Scholar 

  8. Eichelberger MR, Randolph JG (1981) Thoracic trauma in children. Surg Clin North Am 61: 1181–1197

    Google Scholar 

  9. Ein SH, Friedberg J, Shandling B, et al (1986) Traumatic bronchial injuries in children. Pediatr Pulmonol 2: 60–64

    Google Scholar 

  10. El Baz N, Jensick R, Faber LP (1982) One-lung high frequency ventilation for tracheoplasty and bronchoplasty: a new technique. Ann Thor Surg 34: 564–571

    Google Scholar 

  11. Ellis FH, Anderson HA, Hayles AB (1955) Complete traumatic rupture of the bronchus with successful surgical repair: report of a case in a three-year-old child. Proc Staff Meet Mayo Clin 30: 268

    Google Scholar 

  12. Fagenholz SA, Hendren WH (1977) Occult rupture of a main stem bronchus. J Pediatr Surg 12: 509–512

    Google Scholar 

  13. Goldfaden D, Seifert P, Milloy F, et al (1986) Combined tracheal transection and innominate artery discruption from blunt chest trauma. Ann Thor Surg 41: 213–215

    Google Scholar 

  14. Hancock BJ, Wiseman NE (1991) Tracheobronchial injuries in children. J Pediatr Surg 26: 1316–1319

    Google Scholar 

  15. Hsiel C, Ayabe H, Kawahara K, et al (1987) Traumatic disruptive injury of right upper bronchus and truncus intermedius in a five year old boy. J Trauma 27: 333–334

    Google Scholar 

  16. Hughes MJ, Hayes OW, Guertin SR, et al (1986) Traumatic rupture of right main stem bronchus in a child. J Emerg Med 4: 443–447

    Google Scholar 

  17. Jones KW (1980) Thoracic trauma. Surg Clin North Am 60: 957–981

    Google Scholar 

  18. Kelly JP, Webb WR, Moulder PV, et al (1987) Management of airway trauma II: Combined injuries of trachea and esophagus. Ann Thor Surg 43: 160–163

    Google Scholar 

  19. Kilman JW, Charnock E (1969) Thoracic trauma in infancy and childhood. J Trauma 9: 863–873

    Google Scholar 

  20. Kinsella TJ, Johnsrud LW (1947) Traumatic rupture of the bronchus. J Thorac Surg 16: 571–583

    Google Scholar 

  21. Kirsh MM, Orringer MB, Behrendt DM, et al (1976) Management of tracheobronchial disruption secondary to non-penetrating trauma. Ann Thor Surg 22: 93–101

    Google Scholar 

  22. Leape LL (1971) Bronchial avulsion: successful repair after bilateral pneumothorax. J Thorac Cardiovasc Surg 62: 470–472

    Google Scholar 

  23. Longeais Y, Florent GD, Danrigal A, et al (1970) Traumatic rupture of the right main stem bronchus in an eight year old child successfully repaired eight years after injury. Ann Surg 172: 1039–1047

    Google Scholar 

  24. Mahboubi S, O'Hara AE (1981) Bronchial rupture in children following blunt chest trauma. Pediatr Radiol 10: 133–138

    Google Scholar 

  25. Mahaffey DE, Greech O, Boren HG, et al (1956) Traumatic rupture of the left main stem bronchus successfully repaired eleven years after injury. J Thor Surg 32: 312–326

    Google Scholar 

  26. Mahour GH, Lynn HB, Sanderson DR (1967) Rupture of the bronchus. J Pediatr Surg 2: 263–267

    Google Scholar 

  27. Meller JL, Little AG, Shermeta DW (1984) Thoracic trauma in children. Pediatrics 74: 813–819

    Google Scholar 

  28. Mulder DS, Shennib H, Angood P (1986) Thoracic injuries. In: Maull KI, Cleveland HC, Strauch GO, et al (eds) Advances in trauma, vol 1. Chicago, Year Book, pp 193–216

    Google Scholar 

  29. Myers WD, Leape L, Holder TM (1971) Bronchial rupture in a child with subsequent stenosis, resection and anastomosis. Ann Thor Surg 12: 442–445

    Google Scholar 

  30. Nakayama DK, Ramenofsky ML, Rowe MI (1989) Chest injuries in childhood. Ann Surg 210: 770–775

    Google Scholar 

  31. Nonoyama A, Masuda A, Kasahara K, et al (1976) Total rupture of the left main stem bronchus successfully repaired nine years after injury. Ann Thor Surg 21: 445–448

    Google Scholar 

  32. Pizov R, Shir Y, Eimert D, et al (1987) One-lung high frequency ventilation in the management of traumatic tear of bronchus in a child. Crit Care Med 15: 1160–1161

    Google Scholar 

  33. Pratt LW, Smith RJ, Guite LA, et al (1984) Blunt chest trauma with trachobronchial rupture. Ann Otol Rhino Laryngol 93: 357–363

    Google Scholar 

  34. Rahbar A, Chang FC, Farha SJ (1978) Rupture of the bronchus: case report of successful resection and anastomosis in a 13 month old infant. J Trauma 18: 140–141

    Google Scholar 

  35. Rollins RJ, Tocino I (1987) Early radiographic signs of tracheal rupture. Am J Roentgenol 148: 696–698

    Google Scholar 

  36. Roxburgh JC (1987) Rupture of the tracheo-bronchial tree. Thorax 42: 681–688

    Google Scholar 

  37. Sinclair MC, Moore TC (1974) Major surgery for abdominal and thoracic trauma in childhood and adolescence. J Pediatr Surg 9: 155–162

    Google Scholar 

  38. Smyth BT (1979) Chest trauma in children. J Pediatr Surg 14: 41–47

    Google Scholar 

  39. Spencer JA, Rogers CE, Westabyd S (1991) Clinico-radiological correlates in rupture of major airways. Clin Radiol 43: 371–376

    Google Scholar 

  40. Ungar JM, et al (1989) Tears of the trachea and main bronchi caused by blunt trauma: radiologic findings. Am J Roentgenol 153: 1175–1180

    Google Scholar 

  41. Wiot JF (1975) The radiological manifestations of blunt chest trauma. JAMA 231: 500–503

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, New York Medical College, 10595, Valhalla, NY, USA

    Michel S. Slim & Steven Shikiar

  2. Department of Otolaryngology, New York Medical College/Westchester County Medical Center, 10595, Valhalla, NY, USA

    Anthony J. Mortelliti

  3. Department of Radiology, New York Medical College/Westchester County Medical Center, 10595, Valhalla, NY, USA

    A. Brudnicki

  4. Department of Anesthesia, New York Medical College/Westchester County Medical Center, 10595, Valhalla, NY, USA

    E. Frost

Authors
  1. Michel S. Slim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Steven Shikiar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anthony J. Mortelliti
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Brudnicki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. E. Frost
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Slim, M.S., Shikiar, S., Mortelliti, A.J. et al. Tracheobronchial rupture in a child following blunt trauma. Pediatr Surg Int 10, 148–151 (1995). https://doi.org/10.1007/BF00171179

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00171179

Key words

Search

Navigation