Complete transection of bilateral main bronchus in a 5-year-old: A case report

Abstract

Background Tracheobronchial injuries caused by blunt chest trauma are rare in children, and they usually involve multiple organs. Most cases involve respiratory failure on the way to the hospital, and the mortality rate is high. Here, we describe the case of a 5-year-old who fell from an electric vehicle, causing complete rupture of the bilateral main bronchus. Case presentation: Chest computed tomography (CT) failed to detect a bronchial rupture. Continuous closed thoracic drainage resulted in a large amount of bubble overflow. Tracheal rupture was suspected. Fiberoptic bronchoscopy revealed complete rupture of the right main bronchus and rupture of the left main bronchus. Emergency tracheoplasty was performed under cardiopulmonary bypass (CPB). During the operation, we found that the bilateral main bronchi were completely ruptured. Postoperative recovery was smooth. The traditional surgical method for treating these injuries is lateral thoracotomy. However, a median thoracotomy provides a better opportunity for selective repair. Extracorporeal circulation-assisted surgery is required for patients with unstable breathing. Conclusion The patient with completely fracture the bilateral main bronchi is rare. Extracorporeal circulation-assisted tracheoplasty is a relatively safe option in children with difficult respiratory system maintenance, ensuring oxygenation ventilation and a clear surgical field.