Skip to main content
SpringerLink
Log in

Pleural, Lung and Tracheal Injuries

  • Chapter
Operative Techniques and Recent Advances in Acute Care and Emergency Surgery

Abstract

Traumas are the leading cause of death in the first four decades of life: taking into account all age groups, only neoplasms and atherosclerotic disease exceed traumas as the prime cause of death. Many patients die on arrival at the hospital, but many of them can be saved by early diagnosis and immediate and simple medical-surgical treatment. Frequently, in case of pleural and lung injuries, procedures like thoracentesis and chest drain are enough on their own to save the lives of many thoracic trauma patients. On the other hand, tracheobronchial injuries are rare conditions often not recognized at the time of trauma and frequently represent a life-threatening event. Small lesions may be treated conservatively. In case of major injuries (larger than 2 cm), surgical repair is indicated. Extracorporeal life support has emerged as an important adjunct in the context of traumatic airway injuries both in the conservative and in the operative management.

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Wiot J. The radiographic manifestations of blunt chest trauma. JAMA. 1975;231:500–3.

    CAS  PubMed  Google Scholar 

  2. Chopra P, Kroncke G, Berkoff H, et al. Pulmonary contusion: a problem in blunt chest trauma. Wis Med J. 1977;76:S1–3.

    CAS  PubMed  Google Scholar 

  3. Wagner RB, Crawford WO Jr, Schimpf PP. Classification of parenchymal injuries of the lung. Radiology. 1998;167:77–82.

    Google Scholar 

  4. Stevens E, Templeton A. Traumatic nonpenetrating lung contusions. Radiology. 1965;85:247–52.

    CAS  PubMed  Google Scholar 

  5. Erikson D, Shinozaki T, Beekman E, et al. Relationship of arterial blood gases and pulmonary radiographs to the degree of pulmonary contusion. J Trauma. 1971;11:689–94.

    Google Scholar 

  6. Abolhoda A, Livingston DH, Donahoo JS, et al. Diagnostic and therapeutic video assisted thoracic surgery (VATS) following chest trauma. Eur J Cardiothorac Surg. 1997;12:356–60.

    CAS  PubMed  Google Scholar 

  7. Manlulu AV, Lee TW, Thung KH, et al. Current indications and results of VATS in the evaluation and management of hemodynamically stable thoracic injuries. Eur J Cardiothorac Surg. 2004;25:1048–53.

    CAS  PubMed  Google Scholar 

  8. Dennis BM, Gondek SP, Guyer RA, et al. Use of an algorithm for patients with traumatic hemothorax reduces need for additional interventions. J Trauma Acute Care Surg. 2017;82(4):728–32.

    PubMed  Google Scholar 

  9. Carrillo EH, Richardson JD. Thoracoscopy in the management of hemothorax and retained blood after trauma. Curr Opin Pulm Med. 1998;4:243–6.

    CAS  PubMed  Google Scholar 

  10. Hagiwara A, Yanagawa Y, Kaneko N, et al. Indications for transcatheter arterial embolization in persistent hemothorax caused by blunt trauma. J Trauma. 2008;65:589–94.

    PubMed  Google Scholar 

  11. Meyer DM, Jessen ME, Wait MA, et al. Early evacuation of traumatic retained hemothoraces using thoracoscopy: a prospective, randomized trial. Ann Thorac Surg. 1997;64(5):1396–400.

    CAS  PubMed  Google Scholar 

  12. Staats BA, Ellefson RD, Budahn LL, et al. The lipoprotein profile of chylous and nonchylous pleural effusions. Mayo Clin Proc. 1980;55:700–4.

    CAS  PubMed  Google Scholar 

  13. Hillerdal G. Effusions from lymphatic disruptions. In: Light RW, Lee YC, editors. Textbook of pleural diseases. London: Hodder Arnold; 2008. p. 393–4.

    Google Scholar 

  14. Kummer C, Netto FS, Rizoli S, et al. A review of traumatic airway injuries: potential implications for airway assessment and management. Injury. 2007;38:27–33.

    PubMed  Google Scholar 

  15. Huh J, Milliken JC, Chen JC. Management of tracheobronchial injuries following blunt and penetrating trauma. Am Surg. 1997;63:896–9.

    CAS  Google Scholar 

  16. Lee RB. Traumatic injury of the cervico-thoracic trachea and major bronchi. Chest Surg Clin N Am. 1997;7:285–304.

    CAS  PubMed  Google Scholar 

  17. Inci I, Ozçelik C, Taçyildiz I, et al. Penetrating chest injuries: unusually high incidence of high-velocity gunshot wounds in civilian practice. World J Surg. 1998;22:438–42.

    CAS  PubMed  Google Scholar 

  18. Karmy-Jones R, Wood DE. Traumatic injury to the trachea and bronchus. Thorac Surg Clin. 2007;17:35–46.

    PubMed  Google Scholar 

  19. Glazer ES, Meyerson SL. Delayed presentation and treatment of tracheobronchial injuries due to blunt trauma. J Surg Educ. 2008;65:302–8.

    PubMed  Google Scholar 

  20. Farzanegan R, Alijanipour P, Akbarshahi H, et al. Major airways trauma, management and long term results. Ann Thorac Cardiovasc Surg. 2011;17:544–51.

    PubMed  Google Scholar 

  21. Koletsis E, Prokakis C, Baltayiannis N, et al. Surgical decision making in tracheobronchial injuries on the basis of clinical evidences and the injury’s anatomical setting: a retrospective analysis. Injury. 2012;43:1437–41.

    PubMed  Google Scholar 

  22. Mussi A, Ambrogi MC, Ribechini A, et al. Acute major airway injuries: clinical features and management. Eur J Cardiothorac Surg. 2001;20:46–52.

    CAS  PubMed  Google Scholar 

  23. Rossbach MM, Johnson SB, Gomez MA, et al. Management of major tracheobronchial injuries: a 28-year experience. Ann Thorac Surg. 1998;65:182–6.

    CAS  PubMed  Google Scholar 

  24. Rathlev NK, Modzon R, Bracken ME. Evaluation and management of neck trauma. Emerg Med Clin North Am. 2007;25:679–94.

    PubMed  Google Scholar 

  25. Gomez-Caro Andres A, Moradiellos Diez FJ, Ausin Herrero P, Kiaz-Hellin Gude V, Larru Cabrero E, de Miguel Porch E, et al. Successful conservative management in iatrogenic tracheobronchial injury. Ann Thorac Surg. 2005;79:1872–8.

    PubMed  Google Scholar 

  26. Gomez-Caro A, Ausin P, Moradiellos FJ, et al. Role of conservative medical management of tracheobronchial injuries. J Trauma. 2006;61:1426–34.

    PubMed  Google Scholar 

  27. Carretta A, Melloni G, Bandiera A, et al. Conservative and surgical treatment of acute posttraumatic tracheobronchial injuries. World J Surg. 2011;35:2568–74.

    PubMed  Google Scholar 

  28. Bolukbas A, Schirren J. Parenchyma sparing bronchial sleeve resections in trauma, benign and malign diseases. Thorac Cardiovasc Surg. 2010;58:32–7.

    CAS  PubMed  Google Scholar 

  29. Schneider T, Volz K, Dienemann H, et al. Incidence and treatment modalities of tracheobronchial injuries in Germany. Interact Cardiovasc Thorac Surg. 2009;8:571–6.

    PubMed  Google Scholar 

  30. Angelillo-Mackinlay T. Transcervical repair of distal membranous tracheal laceration. Ann Thorac Surg. 1995;59:531–2.

    CAS  PubMed  Google Scholar 

  31. Lee SK, Kim DH, Lee SK, et al. Does surgical repair still have a role for iatrogenic tracheobronchial rupture? Clinical analysis of a thoracic surgeon’s opinion. Ann Thorac Cardiovasc Surg. 2016;22:348–53.

    PubMed  PubMed Central  Google Scholar 

  32. Majercik SD, Ng T, Adams CA, Cioffi WG. Tracheal injury and repair. In: Cioffi WG, Asensio JE, editors. Atlas of trauma/emergency surgical techniques (Chapter 8). New York: Elsevier. p. 82–92.

    Google Scholar 

  33. Reeb J, Olland A, Renaud S, et al. Vascular access for extracorporeal life support: tips and tricks. Thorac Dis. 2016;8(Suppl 4):S353–63.

    Google Scholar 

  34. Zhou R, Liu B, Al LK e. ECMO support for right main bronchial disruption in multiple trauma patient with brain injury—a case report and literature review. Perfusion. 2015;30(5):403–6.

    CAS  PubMed  Google Scholar 

  35. Campione A, Agostini M, Portolan M, et al. Extracorporeal membrane oxygenation in respiratory failure for pulmonary contusion and bronchial disruption after trauma. J Thorac Cardiovasc Surg. 2007;133(6):1673–4.

    PubMed  Google Scholar 

  36. Miñambres E, Burón J, Ballesteros MA, Llorca J, Muñoz P, González-Castro A. Tracheal rupture after endotracheal intubation: a literature systematic review. Eur J Cardiothorac Surg. 2009;35:1056–62.

    PubMed  Google Scholar 

  37. Marty-Ané C-H, Picard E, Jonquet O, Mary H. Membranous tracheal rupture after endotracheal intubation. Ann Thorac Surg. 1995;60(5):1367–71.

    PubMed  Google Scholar 

  38. Ballouhey Q, Fesseau R, Benouaich V, Léobon B. Benefits of extracorporeal membrane oxygenation for major blunt tracheobronchial trauma in the paediatric age group. Eur J Cardiothorac Surg. 2013;43(4):864–5.

    PubMed  Google Scholar 

  39. Fuehner T, Kuehn C, Hadem J, Wiesner O, Gottlieb J, Tudorache I, et al. Extracorporeal membrane oxygenation in awake patients as bridge to lung transplantation. Am J Respir Crit Care Med. 2012;85:763–8.

    Google Scholar 

  40. Son BS, Cho WH, Kim CW. Conservative extracorporeal membrane oxygenation treatment in a tracheal injury: a case report. J Cardiothorac Surg. 2015;10:48.

    PubMed  PubMed Central  Google Scholar 

  41. Swol J, Fülling Y, Ull C, Bechtel M, Schildhauer TA. 48 h cessation of mechanical ventilation during venovenous extracorporeal membrane oxygenation in severe trauma: a case report. J Artif Organs. 2017;20(3):280–4. https://doi.org/10.1007/s10047-017-0949-6.

    Article  PubMed  Google Scholar 

  42. Nakagiri T, Inoue M, Nakagawa J, Okumura M. Blunt tracheal transection repair requiring open abdominal management. Ann Thorac Surg. 2011;92:2248–50.

    PubMed  Google Scholar 

  43. Voelckel W, Wenzel V, Rieger M, Antretter H, Padosch S, Schobersberger W. Temporary extracorporeal membrane oxygenation in the treatment of acute traumatic lung injury. Can J Anaesth. 1998;45:1097–102.

    CAS  PubMed  Google Scholar 

  44. Liu C, Lin Y, Du B, Liu L. Extracorporeal membrane oxygenation as a support for emergency bronchial reconstruction in a traumatic patient with severe hypoxaemia. Interact Cardiovasc Thorac Surg. 2014;19(4):699–701.

    PubMed  Google Scholar 

  45. Korvenoja P, Pitkänen O, Berg E, Berg L. Veno-venous extracorporeal membrane oxygenation in surgery for bronchial repair. Ann Thorac Surg. 2008;86(4):1348–9.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Thoracic Surgery, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Torino, Italy

    Francesco Guerrera & Alberto Oliaro

  2. Department of Thoracic Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Filippo Antonacci

  3. Department of Thoracic Surgery, Institut Lorrain Du Coeur Et Des Vaisseaux Louis Mathieu, Nancy University Hospital, Nancy, France

    Stéphane Renaud

Authors
  1. Francesco Guerrera
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Filippo Antonacci
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stéphane Renaud
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alberto Oliaro
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Dipartimento di Emergenza Urgenza, ASST Grande Ospedale Metropolitano Niguarda, Milan, Milano, Italy

    Paolo Aseni

  2. School of Medicine, University of Milano-Bicocca, Niguarda Hospital, Milan, Milano, Italy

    Luciano De Carlis

  3. Department of Cardiac Surgery, IRCCS MultiMedica, Milan, Milano, Italy

    Alessandro Mazzola

  4. Department of Cardiac Surgery, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy

    Antonino M. Grande

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer International Publishing AG, part of Springer Nature

About this chapter

Cite this chapter

Guerrera, F., Antonacci, F., Renaud, S., Oliaro, A. (2019). Pleural, Lung and Tracheal Injuries. In: Aseni, P., De Carlis, L., Mazzola, A., Grande, A.M. (eds) Operative Techniques and Recent Advances in Acute Care and Emergency Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-95114-0_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-95114-0_20

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-95113-3

  • Online ISBN: 978-3-319-95114-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation