Delayed Presentation and Treatment of Tracheobronchial Injuries Due to Blunt Trauma

Glazer, Evan S.; Meyerson, Shari L.

doi:10.1016/j.jsurg.2008.06.006

Cited by 43 publications

(29 citation statements)

References 19 publications

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“…Nevertheless, a severely traumatized patient with injury, fulfilling the criteria for conservative treatment, located in the distal intrathoracic trachea and carina, seems to be a huge challenge. In cases of complete or almost complete bronchial transections surgery should be the treatment of choice [13]. …”

Section: Discussionmentioning

confidence: 99%

Traumatic tension pneumopericardium and amputation of the left main bronchus

Krawczyk

Byrczek

Łuczyk

et al. 2017

kitp

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A 27-year-old woman sustained a blunt chest trauma after a car accident. Computed tomography revealed tension pneumopericardium, bilateral pneumothorax, and a suspected rupture of the left main bronchus. Emergent pericardial needle aspiration was successfully performed. Bronchial amputation was confirmed by bronchofiberoscopy. Despite total detachment of the distal part of the bronchial tree, the ventilation of the left lung was maintained without air leakage by use of pleural drains. Bronchial obturation resulted from the injury, and was effectively treated by bronchoscopic sputum suction at the distal end of the bronchus. Finally, the patient underwent a left thoracotomy with an end-to-end bronchial anastomosis. The patient was discharged home on the 32nd day after the trauma, and no complications were recorded during a 3-month follow-up period.

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Section: Discussionmentioning

confidence: 99%

Traumatic tension pneumopericardium and amputation of the left main bronchus

Krawczyk

Byrczek

Łuczyk

et al. 2017

kitp

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show abstract

“…Usually, the symptoms in the early stage are nonspecific, such as a stuffy feeling in the chest, shortness of breath, palpitations, etc., which can be confused with the thoracic trauma itself [12]. Gradual worsening of atelectasis induced by the limited cough and respiratory movement may result in sudden dyspnea, cyanosis, and increased thoracic pain.…”

Section: Discussionmentioning

confidence: 99%

Full Airway Drainage by Fiber Bronchoscopy Through Artificial Airway in the Treatment of Occult Traumatic Atelectasis

et al. 2014

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The objective of this study is to investigate the effects of full airway drainage by fiber bronchoscopy through artificial airway in the treatment of traumatic atelectasis with occult manifestations. From May 2006 to May 2011, 40 cases of occult traumatic atelectasis were enrolled into our prospective study. Group A (n=18) received drainage by nasal bronchoscope; group B underwent airway drainage by fiber bronchoscopy through artificial airway (n=22). The effects of treatment were evaluated by the incidence of adult respiratory distress syndrome (ARDS), lung abscess, and the average length of hospital stay. Compared with nasal fiber-optic treatment, airway drainage by fiber bronchoscopy through artificial airway reduced the incidence of ARDS (p=0.013) and lung abscess (p=0.062) and shortened the mean length of stay (p=0.018). Making the decision to create an artificial airway timely and carry out lung lavage by fiber bronchoscopy through artificial airway played a significant role in the treatment of occult traumatic atelectasis.

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“…Protective, well vascularized, tissues should be used to buttress the anastomosis or the bronchial stump, mainly in patients with history of recurrent pulmonary infections. In a review of 27 patients undergoing elective surgery for delayed presentation of TBI between 1996 and 2007 Glazer et al [74] reported that there was no perioperative death and the radiological and functional outcome was excellent in most patients.…”

Section: Reviewmentioning

confidence: 99%

Airway trauma: a review on epidemiology, mechanisms of injury, diagnosis and treatment

Prokakis

Koletsis

Dedeilias

et al. 2014

J Cardiothorac Surg

140

150

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Airway injuries are life threatening conditions. A very little number of patients suffering air injuries are transferred live at the hospital. The diagnosis requires a high index of suspicion based on the presence of non-specific for these injuries symptoms and signs and a thorough knowledge of the mechanisms of injury. Bronchoscopy and chest computed tomography with MPR and 3D reconstruction of the airway represent the procedures of choice for the definitive diagnosis. Endotracheal intubation under bronchoscopic guidance is the key point to gain airway control and appropriate ventilation. Primary repair with direct suture or resection and an end to end anastomosis is the treatment of choice for patients suffering from tracheobronchial injuries (TBI). The surgical approach to the injured airway depends on its location. Selected patients, mainly with iatrogenic injuries, can be treated conservatively as long as the injury is small (<2 cm), a secure and patent airway and adequate ventilation are achieved, and there are no signs of sepsis. Patients with delayed presentation airway injuries should be referred for surgical treatment. Intraoperative evaluation of the viability of the lung parenchyma beyond the site of stenosis/obstruction is mandatory to avoid unnecessary lung resection.

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Delayed Presentation and Treatment of Tracheobronchial Injuries Due to Blunt Trauma

Cited by 43 publications

References 19 publications

Traumatic tension pneumopericardium and amputation of the left main bronchus

Traumatic tension pneumopericardium and amputation of the left main bronchus

Full Airway Drainage by Fiber Bronchoscopy Through Artificial Airway in the Treatment of Occult Traumatic Atelectasis

Airway trauma: a review on epidemiology, mechanisms of injury, diagnosis and treatment

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