Early Diagnosis of Traumatic Rupture of the Bronchus

Management of traumatic tracheobronchial separation in a teenager using a fabricated extra-long endotracheal tube

“…TBS following blunt trauma in children is extremely rare and is associated with a high rate of mortality [1,2]. Our patient's mechanism of injury was a fall from a height of 20 feet, which is consistent with reported causes of TBS such as extensive neck extension and falls from height [3].…”

“…TBS has a 30% mortality rate with more than one half of deaths occurring within the first hour [1,2]. The most common causes of TBS are motor vehicle collisions, sports and domestic accidents, extensive neck extension, falls from height and iatrogenic causes such as traumatic intubation or vigorous external cardiac massage [3,4].…”

An Unusual Case for Thoracic Surgeons: Bronchial Rupture in a Child due to Blunt Chest Trauma

“…High-impact blunt traumas, penetrating trauma with perforating/penetrating instruments or firearms, and iatrogenic injuries may result in tracheobronchial rupture (9). The mortality rate may be up to 30%; half of the mortality is seen within the first hour of the traumatic event (4,5). Wide range of clinical symptoms and signs may be seen, such as pneumothorax, pneumomediastinum, hemothorax, subcutaneous emphysema, hemoptysis and respiratory distress or cyanosis being the most frequent ones (9).…”

“…Bronchial rupture is usually the consequence of a high-speed motor vehicle accident, but it can also be caused by crushing / twisting injuries or by a fall from a height (3). Tracheobronchial rupture has a mortality of almost 30%, with more than half of the deaths occurring within the first hour of the injury (4,5). It is frequently associated with other thoracic or abdominal injuries that can result in delays in diagnosis or even in a failure to diagnose the tracheobronchial injury (6).…”

Complete Tracheal Disruption Following Blunt Trauma

“…During the initial trauma evaluation, this injury may make itself readily apparent. Delayed recognition can lead to tracheal stenosis, bronchiectasis, permanent impairment of lung function, ventilatory failure, mediastinitis, sepsis, and death [2,4,13]. The index of suspicion for this injury is heightened by the presence of a suggestive history and physical examination findings such as shortness of breath, hoarseness, voice changes, stridor, cyanosis, hemoptysis, pain, loss of breath sounds during auscultation of the chest, subcutaneous emphysema, loss of palpable landmarks, and persistent cough.…”