Injuries to the tracheobronchial tree in closed trauma.

Amauchi, W; Birolini, D; Branco, P D; Oliveira, M R de

doi:10.1136/thx.38.12.923

Cited by 34 publications

(25 citation statements)

References 11 publications

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“…Tracheobronchial lesions are rare, occurring in 1% to 3% of patients with closed trauma and 2% to 9% of those who suffered penetrating cervical and/ or thoracic injuries 3,4 . In our series of nine patients with tracheobronchial lesions, two were due to closed trauma.…”

Section: Discussionmentioning

confidence: 99%

“…The literature highlights the presence of pneumothorax in 70% and pneumomediastinum in up to 60% of the cases. The presence of fractures of the first three ribs and sternumclavicular disjunction should also prompt suspicion 3,4,9,11,12 .…”

Section: Discussionmentioning

confidence: 99%

“…Radiological changes are non-diagnostic, but the presence of pneumomediastinum, persistent refractory pneumothorax, atelectasis and subcutaneous emphysema should raise the clinical suspicion of airway injury, and in this case, bronchoscopy should be the examination of choice, which should locate and characterize the lesion 4 . The presence of blood in the airways or difficulty in visualizing the distal bronchial tree may compromise the exam power of resolution.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, some authors recommend repeating the bronchoscopy in the face of clinical suspicion. In intubated patients, where possible, the tube should be removed for proper evaluation 4,6,11,15 . Regarding bronchography, it is believed to have value for chronic lesions, but it is not a recommended test for the diagnosis of injuries soon after trauma, being even contraindicated in this phase by some authors 9 .…”

Section: Discussionmentioning

confidence: 99%

“…In the last decades, with the improvement of prehospital care and transportation, the number of patients with this type of trauma who arrive alive in the emergency room has increased [2][3][4][5] . Success in the diagnosis and treatment of such lesions requires a high level of suspicion, particularly in closed trauma, in which they may go unnoticed due to the occurrence of associated lesions.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Tracheobronchial injuries in chest trauma: a 17-year experience

Saad¹,

Gonçalves²,

Dorgan³

et al. 2017

Rev. Col. Bras. Cir.

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Objective: to discuss the clinical and therapeutic aspects of tracheobronchial lesions in victims of thoracic trauma. Methods: we analyzed the medical records of patients with tracheobronchial lesions treated at the São Paulo Holy Home from April 1991 to June 2008. We established patients' severity through physiological (RTS) and anatomical trauma indices (ISS, PTTI). We used TRISS (Trauma Revised Injury Severity Score) to evaluate the probability of survival. Results: nine patients had tracheobronchial lesions, all males, aged between 17 and 38 years. The mean values of the trauma indices were: RTS - 6.8; ISS - 38; PTTI - 20.0; and TRISS - 0.78. Regarding the clinical picture, six patients displayed only emphysema of the thoracic wall or the mediastinum and three presented with hemodynamic or respiratory instability. The time interval from patient admission to diagnosis ranged from one hour to three days. Cervicotomy was performed in two patients and thoracotomy, in seven (77.7%), being bilateral in one case. Length of hospitalization ranged from nine to 60 days, mean of 21. Complications appeared in four patients (44%) and mortality was nil. Conclusion: tracheobronchial tree trauma is rare, it can evolve with few symptoms, which makes immediate diagnosis difficult, and presents a high rate of complications, although with low mortality.

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Section: Discussionmentioning

confidence: 99%