Rupture of Tracheal Bifurcation Due to the Severe Combined Closed Chest Injury

Тулупов, А. Н.; Мануковский, В. А.; Savello, V. E.; Сафоев, М. И.; Бабич, А. И.

doi:10.24884/0042-4625-2018-177-2-74-77

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“…Клінічний перебіг варіює від безсимптомного до виражених клінічних проявів, які обумовлені розвитком газового та компресійного синдромів або навіть смерті [4,5]. Справжню частоту трахеобронхіальних травм при тупій травмі важко встановити, тому що від 10-20 до 30-80 % пацієнтів, які отримали подібні травми, украй тяжкі та помирають на догоспітальному етапі на місті події або найближчим часом після неї [1,2,6]. Через поліпшення догоспітальної допомоги і ранній початок протоколу розширеної підтримки життя смертність від травматичних пошкоджень дихальних шляхів знизилася з 36 % до 1950 року і 30 % у 1966 році до 9 % у 2001 році [2].…”

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Traumatic tracheal rupture in closed chest trauma (a clinical case)

Getman,

Kravchenko,

Safonov

et al. 2024

ЕМ

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The purpose was to present a clinical case of a soldier with a rupture of the cervical and thoracic parts of the trachea due to closed chest trauma. Early and complete diagnosis of chest injuries, which includes mandatory X-ray and fibrobronchoscopy, can save the life of an injured person, helps choose the optimal method of treatment and improve its outcomes. When choosing the therapeutic approach in patients with traumatic tracheal injuries, it is extremely important to take into account the mechanism of injury, the nature of tracheal damage, the presence and severity of post-traumatic complications, the general condition of the patient, and capacities of a healthcare institution. Given the frequent occurrence in the acute period of life-threatening complications due to traumatic tracheal injury, the formation of gross scarring with the development of tracheal stenosis is possible in the long term, preference is given to active surgical correction of traumatic changes in the tracheal wall. Traumatic injury to the tracheobronchial tree should be suspected in all injured patients with subcutaneous emphysema, hemoptysis, and dyspnea. Adequate examination and treatment of patients with traumatic tracheal rupture requires highly specialized medical care that is based on knowledge, experience, and skills for managing such trauma. X-ray and fibrobronchoscopy must be included in the examination algorithm of such patients. When choosing the treatment approach in patients with traumatic tracheal injuries, it is extremely important to take into account the mechanism of injury, the general condition of the patient, the presence of post-traumatic complications, and capacities of a healthcare institution. Conservative treatment for traumatic tracheal rupture with timely use of minimal surgical interventions can be successful in complete ruptures of the membranous wall of the medium length without development of life-threatening complications.

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